Medicina Fluminensis, Vol. 57 No. 1, 2021.
Case report
https://doi.org/10.21860/medflum2021_365341
Pheochromocytoma: the path from first symptoms to diagnosis - a case report
Romana Marušić
; Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Hrvatska
Tajana Turk
; Katedra za biofiziku i radiologiju, Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Hrvatska
Dunja Degmečić
; Katedra za psihijatriju i psihološku medicinu, Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Hrvatska
Tatjana Bačun
orcid.org/0000-0001-7012-5325
; Katedra za internu medicinu, obiteljsku medicinu i povijest medicine, Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Hrvatska
Abstract
Aim: This case report presents a patient with diagnosed adrenal medulla mass. The patient presented with weight-loss and anxiety. Additional examination of medical records has revealed occasional palpitations, tachycardia and fluctuating blood pressure. Case report: A 62-year-old male patient presented with arterial hypertension, type 2 diabetes, hypercholesterolemia, anxiety, appetite and weight loss of 10 kg in three months. Adominal ultrasound showed and abdominal computerised tomography (CT) scan confirmed a sharply defined heterogenous mass on the right adrenal gland of 4.2x5 cm in diameter, with a density of 26 Hounsfield units. Medical records showed that during the previous four years the patient occasionally suffered from palpitation and supraventricular tachycardia with blood pressure levels up to 190/100mmHg. The laboratory analysis showed elevated plasma levels of metanephrine and normetanephrine (12 and 9 times). Following the surgery, the histopathological examination confirmed the diagnosis of pheochromocytoma. The metanephrine and normetanephrine follow-up results were normal. Annual follow-up is recommended once a year. Conclusion: This case study shows the importance of suspicion of pheochromocytoma with its early detection and the prevention of possible complications. If there is a clinical suspicion of pheochromocytoma or if CT scan rules out adenoma, a biochemical evaluation for pheochromocytoma is mandatory. Unless recognized on time, these tumors have high cardiovascular morbidity and mortality due to their hypersecretion of catecholamines.
Keywords
adrenal tumor; arterial hypertension; palpitation; pheochromocytoma; tachycardia
Hrčak ID:
251273
URI
Publication date:
1.3.2021.
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