# Case report of a huge adrenal pseudocystic tumour with dopamine secretion: treatment paradigm from a very rare case

## TL;DR

This case report describes a rare adrenal tumor that secreted dopamine, causing high blood pressure and tachycardia, which resolved after surgical removal.

## Contribution

The first reported case of a giant adrenal pseudocystic tumor with autonomous dopamine secretion.

## Key findings

- The tumor was successfully removed via minimally invasive surgery with no complications.
- Postoperative dopamine levels normalized, confirming the tumor as the source of excess secretion.
- The patient's hypertension and tachycardia resolved after surgery.

## Abstract

Pheochromocytomas and extra-adrenal paragangliomas are rare neuroendocrine tumors typically characterized by excess secretion of epinephrine and/or norepinephrine. Dopamine secreting tumors are even more uncommon and predominantly extra-adrenal, with only a few solid adrenal ‘dopaminomas’ reported. To the best of our knowledge, we present the first case of a giant right adrenal pseudocystic tumor with autonomous dopamine secretion, incidentally discovered on computed tomography. The lesion was successfully excised via a 3-trocar posterior retroperitoneoscopic adrenalectomy, with an uneventful postoperative course. The patient, previously misdiagnosed with primary hypertension and sinus tachycardia, experienced complete resolution of cardiovascular symptoms postoperatively and discontinued antihypertensives and the b-blocker. Postoperative normalization of dopamine levels confirmed the tumor as the origin of the excess secretion. This case highlights the potential for dopamine-induced secondary hypertension and tachycardia, emphasizing the importance of including dopamine assays in the routine hormonal evaluation of adrenal masses, particularly when large or associated with hypertension and/or tachycardia.