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Case Reports
. 2021 Apr 9:13:20363613211007792.
doi: 10.1177/20363613211007792. eCollection 2021.

Vasoactive intestinal peptide producing pheochromocytoma and intracardiac thrombosis

Melody Hermel  1 , Daniel Jones  2 , Cheryl Olson  3 , Mark Sherman  3 , Ajay Srivastava  1
Affiliations
Case Reports

Vasoactive intestinal peptide producing pheochromocytoma and intracardiac thrombosis

Melody Hermel et al. Rare Tumors. .

Abstract

A case of pheochromocytoma producing vasoactive intestinal peptide (VIP) and left ventricular thrombus in the absence of cardiomyopathy or wall motion abnormalities on echocardiogram is presented along with a review of the relevant literature. A 30-year-old female of Afghani descent with past medical history of panic attacks presented with fever, cough, sore throat, vomiting, and was found to have an 11 cm adrenal mass consistent with primary adrenocortical adenoma versus carcinoma. Her tumor elicited catechols and vasoactive intestinal peptide. Her hospitalization was complicated by left ventricular thrombosis leading to an embolic injury to her right kidney, respiratory failure, need for transient dialysis and urinary tract infections. She developed a profuse secretory diarrhea and decision was made to treat with empiric octreotide infusion and imodium with improvement in symptoms. She underwent coil and particle embolization followed by resection. Followup PET gallium scan showed no evidence of residual disease or metastasis. VIP producing pheochromocytoma associated with intracardiac thrombosis is rare. Outcomes depend on prompt diagnosis of the pheochromocytoma and multidisciplinary approach to management.

Keywords: Thrombus; hypercoagulability; pheochromocytoma; vasoactive intestinal peptide.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Intraoperative photograph of pheochromocytoma.
Figure 2.
Figure 2.
Intraoperative photograph of pheochromocytoma.
See this image and copyright information in PMC

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