Computed tomography appearance of spontaneous adrenal hemorrhage in a pheochromocytoma

Pheochromocytomas are adrenal tumors that are diagnosed with time-consuming 24-h urine collection studies. Adrenal hemorrhage is a rare but serious complication of pheochromocytomas that has been reported in only about 50 cases [Sutton MG, Sheps SG, Lie JT. Prevalence of clinically unsuspected pheochromocytomas. Review of a 50-year autopsy series. Mayo Clin Proc 1981;56:354-360]. We had a patient with a classic presentation of pheochromocytoma complicated with hypertensive crisis leading to spontaneous adrenal hemorrhage. We report the computed tomographic (CT) findings of ruptured pheochromocytoma that helped us in early detection and treatment of this life-threatening complication.