A Case of Pheochromocytoma Presented with Cardiogenic Shock

Abstract

A pheochromocytoma is a catecholamine secreting tumor, which is often overlooked when cardiovascular complications, such as acute heart failure, myocardial infarction, angina pectoris, arrhythmias, and dilated cardiomyopathy, presented as the initial clinical manifestations. Failure to identify a pheochromocytoma in these situations may be fatal. We report the case of 32-year-old female, who presented with cardiogenic shock. Echocardiography revealed severe global hypokinesia of the dilated left ventricl e, with the exception of the apex. Computed tomography of the aorta showed a well-enhanced left adrenal mass, 3.5 cm in diameter. A 24 hour urine collection study for catecholamines and a 131 I-metaiodobenzylguanidine (MIBG) scan were suggestive of the diagnosis of a single adrenal pheochromocytoma. The patient stabilized after shock management, and recovered with intensive medical treatment. Follow-up echocardiography revealed normalized cardiac function and chamber dimensions. Thereafter, the adrenal mass was successfully removed using laparaoscopic surgery, without complications (J Kor Soc Endocrinol 20:283～288, 2005).