Implication of excess iodine intake in Graves-Basedow-disease.

imaging tests performed for another reason, is the most commonly reported in the literature, this was an atypical case of ganglioneuroma. Its atypical features included its location, because only 20--30% of cases occur in the adrenal gland; age at presentation, as these are tumors that may occur in any age group, but more than 80% are reported in patients under 40 years of age, and more than half of these are younger than 20 years; and functionality, because only 30% of ganglioneuromas secrete plasma and urinary catecholamines, and symptoms related to hormone hypersecretion rarely occur in such cases. In this case, endocrine tests showed high levels of chromogranin A, VMA, normetanephrine, and dopamine in the urine. Adrenal mass biopsy should not be performed at the least suspicion of pheochromocytoma or without previously ruling out high catecholamine levels, considerations which were transmitted to the gastroenterology department. Imaging tests were inconclusive and so provided no reliable data for establishing the etiology. Only scintigraphy showed in the late control a strong uptake by the mass suggesting adrenergic overexpression. In this case, hormone and imaging tests not only did not allow us to discriminate between incidentally found adrenal lesions or to make a firm diagnosis, but they also suggested a wrong diagnosis (pheochromocytoma). Pathological examination of the surgical specimen established the final diagnosis of ganglioneuroma.