Pheochromocytoma - An incidental finding in a child with acute appendicitis

Pheochromocytoma, a rare tumour, arises mainly in the adrenal gland. It consists of chromaffin cells or sympathetic para-ganglia if extra-adrenal. It is an occurrence of rare nature with an incidence of two to eight cases per million annually. Incidence of paediatric pheochromocytoma is estimated at 0.11 benign and 0.02 malignant pheochromocytomas per million children. Children with it present with sustained hypertension in contrast to the adult triad of tachycardia, headache, and diaphoresis. We report a case in which the patient initially presented with right iliac fossa pain indicating appendicitis but later when evaluated and assessed, pheochromocytoma was diagnosed as well. The incidental nature of the finding, keeping in mind the rare occurrence makes the outcome interesting and intriguing at the same time.