A rare case of bilateral adrenal pheochromocytoma with unusual presentation: the case report

Authors

  • Nirmal Kumar Madesan Department of General Surgery, Justice K. S. Hegde Medical, Academy, (NITTE Deemed to be University), Mangalore, Karnataka
  • Vinay Kumar J. Rajendra Department of General Surgery, Justice K. S. Hegde Medical, Academy, (NITTE Deemed to be University), Mangalore, Karnataka

DOI:

https://doi.org/10.18203/2349-2902.isj20202430

Keywords:

Adrenal glands, Adrenalectomy, Catecholamines, Chromogranin A, Metanephrine, Normetanephrine

Abstract

Here we report a 25 years old male patient came to our emergency department with chief complaints of headache from 3 months, blurring of vision 7 days, abdominal pain 7 days, and vomiting from 2 days. Young male, with no known comorbidities, presented to our casualty with headache since, 3 months, episodic in nature, increased over the last 1 week, holocranial, gradually progressive in severity. last recorded Blood pressure outside was 220/120 mmHg and papilledema were noted on fundoscopy. USG abdomen and pelvis, CECT abdomen done and diagnosed to have bilateral adrenal pheochromocytoma. Patient underwent bilateral adrenalectomy was performed with good intra op BP control. Right adrenals were enlarged and shows multiple nodular lesions, left adrenal noted shows nodular lesions. Surgery remains the first line of management in malignant pheochromocytoma. Norepinephrine, epinephrine, and dopamine all act on their target receptors, which causes a physiological change in the body. Increase in catecholamines cause severe hypertension and multiple systemic complications like (cardiovascular, cerebrovascular events) and can lead to death if untreated.

Metrics

Metrics Loading ...

Author Biography

Nirmal Kumar Madesan, Department of General Surgery, Justice K. S. Hegde Medical, Academy, (NITTE Deemed to be University), Mangalore, Karnataka

JUNIOR RESIDENT, DEPARTMENT OF GENERAL SURGERY

 K.S.HEGDE MEDICAL ACADEMY NITTE DEEMED TO BE UNIVERSITY

References

Martins R, Bugalho MJ. Paragangliomas/Pheochromocytomas: clinically oriented genetic testing. Int J Endocrinol. 2014;2014:794187.

Li SR, Nicholson KJ, Mccoy KL. Clinical and Biochemical Features of Pheochromocytoma Characteristic of von Hippel-Lindau Syndrome. World J Surg. 2020;44:570-7.

Shea OPM, Griffin TP, Fitzgibbon M. Hypertension: The role of biochemistry in the diagnosis and management. Clinica Chimica Acta. 2017;465:131-43.

Young WF. Management approaches to adrenal incidentalomas. Endocrinology and Metabolism. Clinics of North America. 2000;29(1):159-85.

Ariton M, Juan CS, Ruskin ATW. Pheochromocytoma: Clinical observations from a brooklyn tertiary hospital. Endocrine Practice. 2000;6(3):249-52.

Manger WM. The Protean Manifestations of Pheochromocytoma. Horm Metab Res. 2009;41(09):658-63.

Lenders JWM, Eisenhofer G, Mannelli M. Phaeochromocytoma. Lancet. 2005;366(9486):665-75.

Sutton M, Sheps SG, Lie JL. Prevalence of clinically unsuspected pheochromocytoma. Review of a 50 years autopsy series. Mayo Clinic Proceedings. 1981;56(6):354-60.

Neil MAR, Blok BH, Koelmeyer TD. Phaeochromocytomas discovered during coronial autopsies in Sydney, Melbourne and Auckland. Internal Med J. 2000;30(6):648-52.

Downloads

Published

2020-05-26

Issue

Section

Case Reports