Asymptomatic adrenal medullary hyperplasia detected with intraoperative hypertension: a case report.

We report a rare case of asymptomatic adrenal medullary hyperplasia detected by chance with intraoperative hypertension during surgery for ipsilateral renal cell carcinoma. A 41-year-old male visited our hospital with a complaint of left flank pain. He had normal blood pressure and plasma catecholamine level was within normal limits. Ultrasonogram and CT scan revealed a left renal tumor but did not showed any abnormal masses in the left adrenal gland. The clinical diagnosis was renal cell carcinoma and we performed left total nephrectomy. In the process of operative manipulation, however, the blood pressure and pulse rate of this patient showed a marked increase. Pathological examination of the extirpated kidney revealed renalcell carcinoma, while the resected adrenal gland was diagnosed as adrenal medullary hyperplasia.