Sonographic Findings of Pheochromocytoma in an Adolescent Female During an Evaluation for Possible Renal Artery Stenosis

A 16-year-old female initially presented to urgent care, with a 2-day history of nausea, vomiting, headache, and abdominal pain. After falling and having a tonic/clonic seizure at urgent care, the patient was transferred to an emergency room and subsequently admitted to the pediatric intensive care unit within the hospital for monitoring. Due to persistent tachycardia and hypertension, a renal Doppler examination was performed to evaluate for possible renal artery stenosis. Instead, a 4.0-cm right adrenal mass was discovered, prompting catecholamines and metanephrines testing, and subsequent endocrinology assessment. The diagnosis of pheochromocytoma was made, and a full diagnostic evaluation was completed to exclude extra-adrenal tumor growth and genetic association. Surgical resection of the tumor was successfully accomplished, and the patient was scheduled for annual metanephrine monitoring. This case highlights the significance of a thorough evaluation of the adrenal glands in pediatric patients presenting with atypical hypertension, where renal artery stenosis is suspected.