Adrenal vein sampling for ACTH-producing pheochromocytomas

• Published in: Radiology case reports Vol. 16; no. 9; pp. 2672 - 2675
• Main Authors: Leader, Nicholas, Ushinsky, Alexander, Malone, Christopher D.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-09-2021; Elsevier
• Subjects: ACTH-producing pheochromocytoma; Adrenal vein sampling; Case Report; Pheochromocytoma; Venous intervention; Adrenal vein sampling; ACTH-producing pheochromocytoma; Pheochromocytoma; Venous intervention
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2021.06.055

Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma can cause a variety of clinical manifestations of excess catecholamine and corticosteroid. Anatomic localization of this source of ectopic ACTH is critical to facilitate unilateral adrenalectomy and prevent adrenal insufficiency due to bilateral adrenalectomy. Although nuclear scintigraphy remains the diagnostic gold standard, recent radiotracer supply shortages have necessitated alternative diagnostic paradigms to localize adrenal pheochromocytomas. We present a case where adrenal vein sampling (AVS) was utilized to lateralize an adrenal pheochromocytoma and discuss the approach and nuance as it differs from routine AVS for hyperaldosteronism or hypercortisolism.