The patient went on to have laparoscopic adrenalectomy.


The majority of the tumor is surrounded by a fibrous capsule, which is very attenuated in areas but tumor does not appear to extend to the inked external surface. The tumor shows moderate cytologic atypia with very scant mitotic activity. The tumor shows focal sustentacular pattern of S100 positivity. It is also positive for synaptophysin and neuron specific enolase.

Final Diagnosis: pheochromocytoma

  1. Pheochromocytoma, measuring 3 cm in maximum dimension.
  2. No definite evidence of lymphovascular invasion.

Please note that there is no reliable histological criteria for distinguishing benign versus malignant pheochromocytoma.