Case report of a huge adrenal pseudocystic tumour with dopamine secretion: treatment paradigm from a very rare case

Pheochromocytomas and extra-adrenal paragangliomas are rare neuroendocrine tumors typically characterized by excess secretion of epinephrine and/or norepinephrine. Dopamine secreting tumors are even more uncommon and predominantly extra-adrenal, with only a few solid adrenal 'dopaminomas' reported. To the best of our knowledge, we present the first case of a giant right adrenal pseudocystic tumor with autonomous dopamine secretion, incidentally discovered on computed tomography. The lesion was successfully excised via a 3-trocar posterior retroperitoneoscopic adrenalectomy, with an uneventful postoperative course. The patient, previously misdiagnosed with primary hypertension and sinus tachycardia, experienced complete resolution of cardiovascular symptoms postoperatively and discontinued antihypertensives and the b-blocker. Postoperative normalization of dopamine levels confirmed the tumor as the origin of the excess secretion. This case highlights the potential for dopamine-induced secondary hypertension and tachycardia, emphasizing the importance of including dopamine assays in the routine hormonal evaluation of adrenal masses, particularly when large or associated with hypertension and/or tachycardia.