A 12 year old boy is referred for further evaluation of hypertension, which was detected incidentally at a school health screening program.

He has experienced recurrent headaches, palpitations and episodic sweating for 2 months. The headaches lasted for short durations, and were generalized in nature.

His medical and family histories are unremarkable, and he is not on any drugs. His full blood count, renal functions, serum electrolytes, and urinalysis are normal.

Select Relevant Investigations
Thyroid Profile


TSH: 2.4 mU/L (0.5-5)
T4: 15.6 pmol/l (8 - 27)
T3: 1.5 nmol/l (1- 2.6)
MRA Renal Vessels


The renal vasculature appears completely normal.
MRI Abdomen & Pelvis


There is a right-sided 3.2 × 2.4 cm suprarenal mass, and a left-sided 2 × 1 cm suprarenal mass, both of which exhibit a salt and pepper enhancement pattern and a high signal intensity in the T2 weighted image.
24h Urinary Metanephrines


24h Urinary Fractionated Metanephrines: 2100 mcg/24 hours (<1,300)

Select Relevant Management
Beta Blockers
Surgical Resection