Bilateral Pheochromocytoma- A Diagnostic Dilemma

Bilateral pheochromocytomas are rare and are most often associated with familial diseases. However, sporadic bilateral cases can also occur. Therefore, in any patient with bilateral adrenal masses, a bilateral pheochromocytoma should be suspected, and it is important to determine whether it is familial or sporadic, given the potential risk of tumor recurrence. In this regard, we report the case of a 42-year-old patient, followed for moderate heart failure, who was hospitalized for investigation of newly discovered hypertension. Urinary levels of methoxylated derivatives were very high. Abdominal CT scans revealed the presence of two bilateral adrenal masses. MIBG scintigraphy showed increased uptake in both adrenal glands, without any other localizations. Investigations for multiple endocrine neoplasia or phacomatosis were negative. Treatment consisted of bilateral adrenalectomy via laparoscopy. The patient's progress under hydrocortisone replacement therapy was favorable, with normalization of blood pressure.