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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| Autores principales: | , , , , , , , |
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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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| Sumario: | 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%). |
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