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Norouzi A, Fazel A, Tavassoli S, Mohammadzadeh F. Bilateral Pheochromocytoma Presenting with Only Gastrointestinal Complaints: A Case Report. jcbr. 2017; 1 (1) :33-37
URL: http://jcbr.goums.ac.ir/article-1-26-en.html
Abstract:   (2427 Views)


Introduction: Pheochromocytoma is a rare catecholamine-secreting tumor with gastrointestinal manifestations. Case description: Herein, we report a 50 years old female patient with abdominal pain, altered bowel habit, abdominal mass lesion and laboratory features of pheochromocytoma. The patient was admitted with abdominal pain, back pain, arthralgia, weakness, lethargy, cold sweat and weight loss. She had history of diabetes mellitus, ischemic heart disease and hyperlipidemia. On admission, she was normotensive and had normal physical examination. Upper and lower endoscopies were normal. Transabdominal sonography and CT scan showed large heterogeneous masses with central necrosis and calcification in adrenal regions. In addition, 24-hour urine evaluation showed elevated vanillylmandelic acid, metanephrine and normetanephrine levels. She underwent bilateral adrenalectomy. Pathologic evaluation showed typical characteristics of pheochromocytoma. Conclusions: In any patient with abdominal pain and abdominal mass, low threshold for diagnosis of rare but often lethal pheochromocytoma is suggested.

KEYWORDS: pheochromocytoma, constipation, abdominal pain

Full-Text [PDF 427 kb]   (832 Downloads)    
Article Type: Research | Subject: Statistics and epidemiology
Received: 2017/01/19 | Accepted: 2017/03/15 | Published: 2017/05/14

1. Yau JS, Li JK, Tam VH, Fung LM, Yeung CK, Chan KW, et al. Phaeochromocytoma in the Hong Kong Chinese population. Hong Kong Med J. 2010;16(4):252-6.
2. Kek PC, Ho ETL, Loh LM. Phaeochromocytoma presenting with pseudo-intestinal obstruction and lactic acidosis. Singapore Med J. 2015; 56(8): e131–e133. [DOI:10.11622/smedj.2015126]
3. Kumar P, Ghosh S, Tanwar HS, Gupta AK. Acrocyanosis in a young adult: a rare presentation of extra-adrenal pheochromocytoma. BMJ Case Rep. 2014. [DOI:10.1136/bcr-2013-202845]
4. Van Berkel A, Lenders JW, Timmers HJ. Diagnosis of endocrine disease: Biochemical diagnosis of phaeochromocytoma and paraganglioma. Eur J Endocrinol. 2014;170(3):R109-19. [DOI:10.1530/EJE-13-0882]
5. Williams Textbook of Endocrinology 12th Edition .vol1: 548-549.
6. Goodman L, Gilman A. The pharmacologic basis of therapeutics. NewYork: MacMillan. 1985; 14.
7. Turner CE.Gastrointestinal pseudo-obstruction due to pheochromocytoma. Am J Gastroenterol. 1983;78:214-7.
8. Salazar A, Naik A, Rolston DD. Intestinal pseudoobstruction as apresenting feature of a pheochromocytoma. J ClinGastroenterol. 2001;33:253-4. [DOI:10.1097/00004836-200109000-00020]
9. Sohn CI, Kim JJ, Lim YH, et al. A case of ischemic colitis associated with pheochromocytoma. AmJ Gastroenterol. 1998;93:124-6. [DOI:10.1111/j.1572-0241.1998.124_c.x]
10. Szmulowicz UM, Savoie LM. Ischemic colitis: an uncommon manifestation of pheochromocytoma. Am Surg. 2007;73:400-3.
11. Short IA, Padfield PL. Malignant phaeochromocytoma with severe constipation and myocardial necrosis. Br Med J. 1976;2:793-4. [DOI:10.1136/bmj.2.6039.793-a]
12. Thurttle OA, Allen AP, Walters MT, et al. Intractable constipation in malignant pheochromocytoma: combined treatment with adrenergic blockade and cholinergic drugs. Royal Soc Med. 1984;77:327-8. [DOI:10.1177/014107688407700414]
13. GiffordRW, Kvale WF, Maher FT, Roth GM, Priestley JT. Clinical features, diagnosis and treatment of pheochromocytoma: a review of 76 cases. Mayo Clin Proc. 1964; 39:281-302.
14. Zulmari CS, Juan CC, Ortiz-Betancourt JM, An unusual presentation of pheochromocytoma. Crit Care & Shock. 2011; 14:46-51.
15. Shah D, Reiser J. Chronic Abdominal Pain: \"The Great Masquerader\". Practical Gastroenterology; December 2010.
16. Kopetschke R, Slisko1 M, Kilisli A, et al. Frequent incidental discovery of pheochromocytoma: data from a German cohort of 201 pheochromocytoma. European Journal of Endocrinology. 2009; 161: 355–361. [DOI:10.1530/EJE-09-0384]
17. Duffy TJ, Erickson EE, Jordan GL, Bennett HD. Megacolon and bilateral pheochromocytoma. Am J Gastroenterol.1962; 38:555–563.
18. Suba AR. Bilateral pheochromocytoma with megacolon. Mol Med. 1971; 68:256 –258.
19. Francis RS. X-Ray of the month. J Tenn Med Assoc.1976; 69:114 –142.
20. Cruz SR, Colwell JA. Pheochromocytoma and ileus. JAMA. 1972; 219:1050 –1051. [DOI:10.1001/jama.1972.03190340056012]
21. MullenJP, Cartwright RC, Tisherman SE, Misage JR, Shapiro AP. Case report: pathogenesis and pharmacologic management of pseudo-obstruction of the bowel in pheochromocytoma. Am J Med Sci. 1985; 290:155–158. [DOI:10.1097/00000441-198510000-00004]
22. Turner CE. Gastrointestinal pseudo-obstruction due to pheochromocytoma. Am JGastroenterol.1983; 78:214 –217.
23. Sweeney AT, Malabanan AO, Blake MA, de lasMorenas A, Cachecho R, Melby JC. Megacolon as the presenting feature in pheochromocytoma. J ClinEndocrinolMetab. 2000;85:3968-72. [DOI:10.1210/jcem.85.11.6947]
24. Kolhe N, Stoves J, Richardson D, Davison AM, Gilbey S. Hypertension due to phaeochromocytoma an ununsual cause of multiorgan failure. Nephrol Dial Transplant. 2001;16:2100-4. [DOI:10.1093/ndt/16.10.2100]
25. Brouwers FM, Eisenhofer G, Lenders JW, Pacak K. Emergencies caused by pheochromocytoma, neuroblastoma, or ganglioneuroma. Endocrinol Metab Clin North Am. 2006;35:699-724. [DOI:10.1016/j.ecl.2006.09.014]
26. Kousseff BG. Multiple endocrine neoplasia 2 (MEN 2)/MEN 2A (Sipplesyndrome). DermatolClin.1995;13:91.
27. Wohllk N, Schweizer H, Erlic Z, Schmid KW, Walz MK, Raue F, et al. Multipleendocrine neoplasia type 2. Best Pract Res ClinEndocrinolMetab 2010;24:371–87. [DOI:10.1016/j.beem.2010.02.001]

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