Introduction (148 words):

Autosomal dominant polycystic kidney disease (ADPKD) is the most common form of polycystic kidney disease (PKD), with an incidence of 1/400-1000 births. Approximately 85% of cases are caused by a PKD1 gene mutation and 15% by a PKD2 gene mutation, making it the most common genetic disease leading to end-stage renal failure by the age of 70 [1]. Between the ages of 20 and 34, 50% of patients with ADPKD and unaltered renal function have hypertension; among patients with end-stage renal disease, this ratio rises to nearly 100% [1]. This report presents a rare case of an ADPKD patient with concurrent sarcoma recurrence and unsuspected pheochromocytoma and paraganglioma (PPGLs), highlighting the diagnostic and therapeutic challenges. While ADPKD commonly presents with hypertension, it is important to consider secondary causes, such as PPGLs, since there have been a few reports of ADPKD linked to neuroendocrine tumours [2-5].