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To the editor:A 38-year-old woman suffered from repeatedly episodes of headache,palpitations and sweating for 5 days before admission.Her elder sister has pheochromocytoma and medullary thyroid cancer (MTC),while her niece has MTC.Further physical examinations disclosed paroxysmal hypertension and bilateral thyroid large nodules.An enhanced computed tomography (CT) revealed adrenal mass in both sides,with 7 cm by 8 cm in the left and 1 cm by 2 cm in the right (Figure 1A).An octreotide somatostatin receptor image only confirmed a focus of intense uptake in the left side of adrenal.Meanwhile,plasma calcitonin was 352.84ng/L (reference range 0-100).Both ultrasonography and CT (Figure 1E) disclosed thyroid malignant nodules in both lobules.Moreover,the parathyroid hormone was 146 pg/ml (15-683);a parathyroid ultrasonography revealed a left lower dorsal lobe parathyroid adenoma.Therefore,laparoscopic left adrenalectomy was first performed followed by total thyroidectomy and parathyroidectomy two weeks later.