Compound adrenal medullary tumor.

Compound tumors of the adrenal medulla, characterized by a mixture of pheochromocytoma and ganglioneuroma, are rare, only 12 cases having been reported in the literature. We present the case of a 66-year-old woman with a left-sided incidentally discovered adrenal mass that was subsequently shown to contain elements of pheochromocytoma and ganglioneuroma. The patient had no history of hypertension but did have a history of "idiopathic" edema (dependent edema). A review of the literature shows hormonal hypersecretion in approximately three fourths of the reported cases. Because of the preoperative hypertensive crises from the pheochromocytoma component of the tumor, contemporary management of incidentally discovered adrenal masses must include preoperative hormonal evaluations to exclude endocrine hyperfunction.