reported 35 abdominal dopamine secreting pheochromocytomas or “dopaminomas” since 1980 in the literature. Functional pheochromocytomas that produce dopamine primarily or exclusively are extremely rare. Initial testing usually begins with plasma-free metanephrines or 24-hour urinary fractionated metanephrines. Classic symptoms are due to excess adrenaline and/or noradrenaline production. The classic symptoms consist of episodic headache, sweating, and tachycardia but may be present in only 50% of patients and are usually paroxysmal. The annual incidence of pheochromocytoma/paragangliomas is approximately 0.8/100,000 person-years. Pheochromocytomas or paragangliomas are neuroendocrine tumors that arise from chromaffin cells. At two years of follow-up there was no recurrence and normalization of lab values. The patient underwent full metastatic workup, which was negative. Pathology revealed increased malignant potential associated with the tumor. The patient successfully underwent robotic assisted radical left adrenalectomy and was diagnosed with a dopamine secreting pheochromocytoma. 24-hour urine dopamine levels (6988 μg/day) were significantly elevated. MRI gave concerns for possible pheochromocytoma but markers for pheochromocytoma were not elevated as expected. We report on a 43-year-old, asymptomatic female who presented with incidental finding of left adrenal mass.
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