The good, the bad, and the ugly: uncommon CT appearances of pheochromocytoma.

Pheochromocytoma is a neuroendocrine tumor arising in the adrenal medulla with varied imaging appearances and associated risk of serious cardiovascular complications if left undiagnosed and untreated. It is discovered incidentally in up to 70% of cases due to the increase in use of CT in clinical practice. Biopsy can have life-threatening consequences, so imaging is crucial for diagnosis and surgical planning. The purpose of this review is to demonstrate unusual CT appearances of pheochromocytoma and enhance diagnostic confidence in cases discovered incidentally. High level of suspicion for pheochromocytoma based on CT findings, along with urinary metanephrine levels, can obviate the need for additional expensive imaging.