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Case Reports: Reminder of important clinical lesson
Subclinical phaeochromocytoma: a diagnostic and management challenge
  1. Ying Jie Chee1,
  2. Clarence Hai Yi Teo2,
  3. Rebecca Tian Mei Au2 and
  4. Yin Chian Kon1
  1. 1Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
  2. 2Department of Pathology, Tan Tock Seng Hospital, Singapore, Singapore
  1. Correspondence to Dr Ying Jie Chee; cheeyingjie{at}gmail.com

Abstract

There is a paradigm shift in the detection of phaeochromocytomas with more being identified as adrenal ‘incidentalomas’. While majority of these individuals are asymptomatic, they are nevertheless at risk of subtle cardiovascular dysfunction and phaeochromocytoma crises. Therefore, early resection of phaeochromocytomas, even if subclinical, is recommended. However, the perioperative management can be challenging as the normotension can limit the initiation and titration of alpha-blockade. We present a man in his 60s with a subclinical phaeochromocytoma, discuss the evaluation of an incidentally discovered adrenal nodule, as well as the practical considerations in the perioperative management.

  • Endocrinology
  • Adrenal disorders

https://doi.org/10.1136/bcr-2021-248571

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    Footnotes

    • Contributors YJC was the primary physician and was involved in the conception of the idea for the case report, as well as the acquisition, interpretation, analysis of the data and writing the manuscript. YCK was the supervising consultant endocrinologist and was involved in the conception of the idea for the case report, as well as the interpretation, analysis of the data and critically reviewed the manuscript. CHYT and RTMA were involved in the acquisition, analysis, interpretation of data and critically reviewed the manuscript. All authors approved the final version before submission and agree to be accountable for the article, including ensuring that questions related to the accuracy or integrity of the article are appropriately investigated and resolved.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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