A CASE OF GIANT PHEOCHROMOCYTOMA

Abstract

Objective: Pheochromocytomas are rare tumours originating in chromaffin cells which predominantly are located in adrenal glands They are a representation of 0.1%-1% of all cases of secondary hypertension. Pheochromocytoma is the most typical cause of hypertension by promoting hypertension remission in the majority of patients after surgical procedure. Sustained or paroxysmal hypertension is the most frequent sign of pheochromocytoma, possibly associated with the classic triad: episodic headaches, sudoresis and tachycardia. We present a case of giant right adrenal pheochromocytoma. Design and method: A 52-year-old female patient presented with nausea, vomiting, mild discomfort at right flank, headache and resistant hypertension. She had unexplained orthostatic hypotension, and could not even get out of bed Results: Her ABPM shows an optimal hypertension in 65% of measurements, and a peak of hypertension about 204/110mmHg. The CT scan of head was normal and the CT scan of the abdomen showed a heterogeneous mass lesion between the right hepatic lobe and the right kidney, with central necrosis, dimensions 90x94x93 mm, probable with the origin of the right adrenal gland. Urine catecholamines levels were high, and urine metanephrines were 3-fold higher than the normal ranges. Conclusions: After surgery, the patient discharge home with controlled BP without need for antihypertensive medication. At 1-year follow-up, she remained asymptomatic and with normal serum metanephrine values.