Composite pheochromocytoma - neuroblastoma of the adrenal gland associated with systemic lupus erythematosus; diagnosed on cytology

Composite pheochromocytoma (CP) is a rare tumor of the adrenal medulla that refers to a pheochromocytoma that has a component resembling neuroblastoma, ganglioneuroblastoma, ganglioneuroma or even a malignant peripheral nerve sheath tumor. There are very few reported cases of CP, with majority of the cases having elements of ganglioneuroma with pheochromocytoma. We report the case of a 27-year-old female with a history of systemic lupus erythematosus, sustained hypertension, and an adrenal mass. Computed tomography guided fine needle aspiration cytology of the mass revealed CP with elements of neuroblastoma. We report this case because of its rarity.