| Summary: | A 78-year-old woman was referred to our institution for evaluation and treatment of a mass on her right adrenal gland measuring 12 × 11 × 10 cm. Twenty-four–hour urine analysis revealed a total metanephrine level over 3 times the upper limit of normal. Scintigraphy using 123I-metaiodobenzylguanidine was positive. The mass was resected en bloc by laparotomy after a laparoscopic attempt was unsuccessful. Histopathologic examination revealed a pheochromocytoma of the right adrenal gland, weighing 576 g. The Grading System for Adrenal Pheochromocytoma and Paraganglioma score was 6, and the histology of the tumor was a moderately differentiated type.
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