Eric O. Gamboa, MD

A 57-year-old man was referred to the oncology clinic with a 1.5-year history of cough without hemoptysis and progressive dysphagia, resulting in a 65-lb weight loss, approximately one-third of his baseline weight.

A 26-year-old woman with a past medical history significant for congenital heart disease, status-post multiple surgical interventions, congestive heart failure, scoliosis, and diabetes was initially found to have significant hypertension in 1997. CT scan of the abdomen and pelvis with contrast revealed a low density mass in the retrocaval region, thought to be a mass in the right adrenal gland, and a large, heterogeneous liver, suggestive of passive congestion vs. diffuse metastatic disease. A Doppler ultrasound of the renal arteries revealed no evidence of stenosis. A subsequent MRI of the abdomen confirmed the presence of a 3 cm × 2 cm right adrenal mass with moderate increased signal intensity on T2 and STIR images, and iso-intense on T1. Due to her history, this was felt to represent a pheochromocytoma. The liver was increased in size, but there was no evidence of metastatic liver lesions. OctreoScan revealed no evidence of uptake. A 24-hour urine collection for catecholamines was elevated.