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Malignant pheochromocytoma: pain, palpitation, perspiration and perplexities
  1. Nanditha Ananthakrishnan1,
  2. Saravanan Sanniyasi1 and
  3. Daniel Ravikumar2
  1. 1Department of General Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, India
  2. 2Department of General Surgery, ESI Hospital (Ayanavaram), Chennai, India
  1. Correspondence to Nanditha Ananthakrishnan; totogiffe{at}gmail.com

Abstract

A 60-year-old man presented with headache, giddiness, abdominal pain and palpitation. When evaluated outside for the same, the patient was diagnosed to have hypertension and started on antihypertensives for which he did not respond. ECG was suggestive of non-ST elevation myocardial infarction. The patient was subjected to a coronary angiogram, which was normal. Patient had multiple episodes of fluctuating blood pressures. CT of the abdomen showed a 7.1×5.6×8.2 cm mass in the left adrenal gland suggestive of a pheochromocytoma. Serum, urine metanephrines and normetanephrines were elevated. After discussing with the multidisciplinary team, the patient was stabilised with alpha blockers and taken up for laparoscopic left adrenalectomy. Histopathology was reported as pheochromocytoma with a Pheochromocytoma Adrenal Scaled Score of 10/20 suggestive of malignancy. This is one such case of a malignant pheochromocytoma, which was managed successfully despite the perplexities faced in stabilising the crisis followed by laparoscopic resection in a moribund patient.

  • Hypertension
  • Adrenal disorders
  • Endocrine cancer
  • Surgery

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Footnotes

  • Contributors NA: drafting the manuscript. SS: primary surgeon, review of literature and final approval. DR: review of literature.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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