Multifocal malignant pheochromocytoma presenting as a lung tumor

An unusual case of pheochromocytoma, which presented as a primary lung tumor, is described. The tumor was multifocal, arising in both the adrenal glands and in the chromaffin tissue around the thoracic aorta; it had invaded the lung and metastasized to the brain. Histologically the tumor had an unusual sarcomatous appearance, and the final diagnosis depended on the ultrastructural finding of scanty amounts of neurosecretory granules, typical of epinephrine and norepinephrine. This is the first reported case of pheochromocytoma presenting clinically as a lung tumor.