Pheochromocytoma: A Troublesome Tumor

Abstract

This report presents the case of a 45-year-old man with a history of episodic headaches, palpitations, and sweating for the past six months. His blood pressure on admission was 170/100 mmHg. The patient was diagnosed with pheochromocytoma confirmed by elevated levels of plasma catecholamines and metanephrines. CT imaging revealed a 3 cm mass in the left adrenal gland with evidence of local invasion into the surrounding tissues. The patient underwent a laparoscopic adrenalectomy and was discharged on the third postoperative day with normal blood pressure. Histopathological examination confirmed the diagnosis of pheochromocytoma. The patient was followed for six months postoperatively with the resolution of symptoms and no evidence of tumor recurrence on imaging. Recurrence involves complex environment-gene interactions that are poorly understood. The diagnosis of pheochromocytoma could take several weeks to several years mainly because the symptoms are nonspecific and episodic. Although sudden death is rare, the debilitations associated with pheochromocytoma are often multisystemic with cardiovascular, emotional, and metabolic components. This case report highlights the importance of early diagnosis, appropriate management, and follow-up for pheochromocytoma.

Keywords: abdominal radiology; adrenal pheochromocytoma; differential diagnosis; multiple endocrine neoplasia; von hippel-lindau disease.

Figure 1. Abdominal magnetic resonance imaging (MRI) scan.

Arrow points to a clearly visible 3 cm pheochromocytoma in the left retroperitoneal flank region of a 45-year-old man who presented with a history of episodic headaches, palpitations, and sweating for the past six months.

Figure 2. Abdominal computed tomography (CT) scan.

Arrow points to a 3 cm pheochromocytoma deep in the left retroperitoneal flank region of a 45-year-old man who presented with a history of episodic headaches, palpitations, and sweating for the past six months.