Pheocromocytoma: Case report
Pheochromocytoma is a catecholamine-producing tumor originating from neuroendocrine cells located in the adrenal medulla. 85% is located in the adrenal medulla and the rest in the extra-adrenal chromaffin tissue (paraganglioma). It is one of the most frequent causes of secondary arterial hypertensio...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/38938 |
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I10-R327-article-38938 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
pheochromocytoma tomography norepinephrine hypertension feocromocitoma tomografía noradrenalina hipertensión . |
| spellingShingle |
pheochromocytoma tomography norepinephrine hypertension feocromocitoma tomografía noradrenalina hipertensión . Marinaro , A Rojas , AB Corona , A Carrizo, FG Rios , G Bartoli , C García Brasca , D Simondi, H Pheocromocytoma: Case report |
| topic_facet |
pheochromocytoma tomography norepinephrine hypertension feocromocitoma tomografía noradrenalina hipertensión . |
| author |
Marinaro , A Rojas , AB Corona , A Carrizo, FG Rios , G Bartoli , C García Brasca , D Simondi, H |
| author_facet |
Marinaro , A Rojas , AB Corona , A Carrizo, FG Rios , G Bartoli , C García Brasca , D Simondi, H |
| author_sort |
Marinaro , A |
| title |
Pheocromocytoma: Case report |
| title_short |
Pheocromocytoma: Case report |
| title_full |
Pheocromocytoma: Case report |
| title_fullStr |
Pheocromocytoma: Case report |
| title_full_unstemmed |
Pheocromocytoma: Case report |
| title_sort |
pheocromocytoma: case report |
| description |
Pheochromocytoma is a catecholamine-producing tumor originating from neuroendocrine cells located in the adrenal medulla. 85% is located in the adrenal medulla and the rest in the extra-adrenal chromaffin tissue (paraganglioma). It is one of the most frequent causes of secondary arterial hypertension. It is found in 0.1 to 1% of hypertensive patients of any age, with a peak from puberty to 40 years of age. In 85% of cases, they are single tumors without a family pattern. However, they can be multiple and familiar. The most frequent location is in the abdomen (95%).
PRESENTATION OF THE CASE. A 51-year-old male patient with a history of hypertension, benign prostatic hyperplasia, and a former smoker. Medicated with Losartan 50mg, Carvedilol 12.5mg and Terazocine 5mg. Patient who consulted due to intense holocranial headache of 8 months of evolution associated with palpitations. On physical examination: BMI: 29.49 kg/m2, blood pressure 260/120 mmHg, HR 77 bpm, hyperphonetic heart sounds, no murmurs, good distal perfusion. The Electrocardiogram was normal. The laboratory evidenced: Plasma adrenaline: 14 pgr/ml (NV: 0-100 pgr/ml), plasma noradrenaline 410 pgr/ml (NV: 70-700 pgr/ml), plasma dopamine 121 pgr/ml (NV: 0-50 pgr/ml), urinary metanephrines: 33 µgr/24 h (NV: 44-261 µgr/24 hours), urinary normetanephrine 572 µgr/24 h (103-521 µgr/24 hours), vanillin mandelic acid 8.8 mgr/24 h (NV: 2.3-5.1 mgr/24 hours), urinary epinephrine 5.1 µgr/24 h (NV: 0.9-20 µgr/24 hours), urinary norepinephrine 162.2 µgr/24 h (NV: 15-80 µgr/24 hours) and urinary dopamine 238 µg/24 h (NV: 65-400 µg/24 hours). Interpreting itself as a producer of norepinephrine. Abdominal tomography with contrast showed a nodular image in the right adrenal gland of 49 x 49 x 33 mm, compatible with pheochromocytoma. Surgical treatment was performed whose biopsy confirmed the diagnosis. Subsequently, the doses of antihypertensive drugs were decreased.
The diagnosis of pheochromocytoma requires a high clinical suspicion, catecholamine dosage and abdominal tomography. Surgical removal is essential, as it is one of the few forms of potentially curable hypertension (0.2%). |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2022 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/38938 |
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I10-R327-article-389382024-04-15T16:14:45Z Pheocromocytoma: Case report Feocromocitoma: Reporte de un caso . Marinaro , A Rojas , AB Corona , A Carrizo, FG Rios , G Bartoli , C García Brasca , D Simondi, H pheochromocytoma tomography norepinephrine hypertension feocromocitoma tomografía noradrenalina hipertensión . Pheochromocytoma is a catecholamine-producing tumor originating from neuroendocrine cells located in the adrenal medulla. 85% is located in the adrenal medulla and the rest in the extra-adrenal chromaffin tissue (paraganglioma). It is one of the most frequent causes of secondary arterial hypertension. It is found in 0.1 to 1% of hypertensive patients of any age, with a peak from puberty to 40 years of age. In 85% of cases, they are single tumors without a family pattern. However, they can be multiple and familiar. The most frequent location is in the abdomen (95%). PRESENTATION OF THE CASE. A 51-year-old male patient with a history of hypertension, benign prostatic hyperplasia, and a former smoker. Medicated with Losartan 50mg, Carvedilol 12.5mg and Terazocine 5mg. Patient who consulted due to intense holocranial headache of 8 months of evolution associated with palpitations. On physical examination: BMI: 29.49 kg/m2, blood pressure 260/120 mmHg, HR 77 bpm, hyperphonetic heart sounds, no murmurs, good distal perfusion. The Electrocardiogram was normal. The laboratory evidenced: Plasma adrenaline: 14 pgr/ml (NV: 0-100 pgr/ml), plasma noradrenaline 410 pgr/ml (NV: 70-700 pgr/ml), plasma dopamine 121 pgr/ml (NV: 0-50 pgr/ml), urinary metanephrines: 33 µgr/24 h (NV: 44-261 µgr/24 hours), urinary normetanephrine 572 µgr/24 h (103-521 µgr/24 hours), vanillin mandelic acid 8.8 mgr/24 h (NV: 2.3-5.1 mgr/24 hours), urinary epinephrine 5.1 µgr/24 h (NV: 0.9-20 µgr/24 hours), urinary norepinephrine 162.2 µgr/24 h (NV: 15-80 µgr/24 hours) and urinary dopamine 238 µg/24 h (NV: 65-400 µg/24 hours). Interpreting itself as a producer of norepinephrine. Abdominal tomography with contrast showed a nodular image in the right adrenal gland of 49 x 49 x 33 mm, compatible with pheochromocytoma. Surgical treatment was performed whose biopsy confirmed the diagnosis. Subsequently, the doses of antihypertensive drugs were decreased. The diagnosis of pheochromocytoma requires a high clinical suspicion, catecholamine dosage and abdominal tomography. Surgical removal is essential, as it is one of the few forms of potentially curable hypertension (0.2%). El feocromocitoma es un tumor productor de catecolaminas originado en las células neuroendocrinas ubicadas en la medula suprarrenal. El 85% se localiza en la medula adrenal y el resto en el tejido cromafín extra adrenal (Paraganglioma). Es una de las causas más frecuente de hipertensión arterial secundaria. Se halla en el 0,1 a 1% de los hipertensos de cualquier edad, con un pico desde la pubertad hasta los 40 años. En el 85% de los casos son tumores únicos sin un patrón familiar. Sin embargo, pueden ser múltiples y familiares. La localización más frecuente es en abdomen (95%). PRESENTACION DEL CASO. Paciente masculino de 51 años, con antecedentes de HTA, hiperplasia benigna de próstata y ex tabaquista. Medicado con Losartan 50 mg, Carvedilol 12,5 mg y terazocina 5mg. Paciente que consultó por cefalea holocreaneana intensa de 8 meses de evolución asociada a palpitaciones. Al examen físico: IMC: 29,49 kg/m2, tensión arterial 260/120 mmHg, FC 77 lpm, ruidos cardíacos hiperfonéticos, sin soplos, buena perfusión distal. El Electrocardiograma fue normal. El laboratorio evidenció: Adrenalina plasmática: 14 pgr/ml (VN: 0-100 pgr/ml), noradrenalina plasmática 410 pgr/ml (VN: 70-700 pgr/ml), dopamina plasmática 121 pgr/ml (VN: 0-50 pgr/ml), metanefrinas urinarias: 33 µgr/24 hs (VN: 44-261 µgr/24 hs), normetanefrina urinaria 572 µgr/24 hs (103-521 µgr/24 hs), ácido vainillin mandélico 8.8 mgr/24 hs (VN: 2.3-5.1 mgr/24 hs), adrenalina urinaria 5.1 µgr/24 hs (VN: 0.9-20 µgr/24 hs), noradrenalina urinaria 162.2 µgr/24 hs (VN: 15-80 µgr/24 hs) y dopamina urinaria 238 µgr/24 hs (VN: 65-400 µgr/24 hs) . Interpretándose como productor de noradrenalina. La Tomografía de abdomen con contraste evidencio una imagen nodular en la glándula suprarrenal derecha de 49 x 49 x 33 mm, compatible con feocromocitoma. Se realizó tratamiento quirúrgico cuya biopsia confirmo el diagnóstico. Posteriormente, se disminuyeron las dosis de las drogas antihipertensivas. El diagnóstico del feocromocitoma requiere una alta sospecha clínica, el dosaje de catecolaminas y la tomografía de abdomen. La extirpación quirúrgica es fundamental, ya que constituye una de las pocas formas de hipertensión arterial potencialmente curables (0.2 %). . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-10-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto . https://revistas.unc.edu.ar/index.php/med/article/view/38938 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. Suplemento JIC XXIII (2022): Suplemento JIC XXIII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |