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A case of normotensive pheochromocytoma with management dilemma
- Source :
- Indian Journal of Endocrinology and Metabolism, Vol 16, Iss 8, Pp 371-372 (2012), Indian Journal of Endocrinology and Metabolism
- Publication Year :
- 2012
- Publisher :
- Medknow, 2012.
-
Abstract
- Introduction: We report an unusual case of normotensive pheochromocytoma detected incidentally, presenting a pre-operative management problem. Case Note: A 40-year-old lady with vague abdominal symptoms was initially discovered with a left adrenal incidentaloma by ultrasound abdomen, which was also revealed in computed tomography (CT). After exclusion of all the causes with possible necessary investigations, pheochromocytoma was confirmed with elevated 24 hour urinary metanephrine and normetanephrine. Her blood pressure was in low to normotensive range all throughout. She was attempted to be prepared with combined alpha and beta blockade but could not tolerate this regimen due to symptomatic hypotension. Subsequently, surgical preparation was planned cautiously with alpha-adenergic blockade only. With intensive monitoring, she underwent uneventful left adrenalectomy, and surgical pathology was consistent with pheochromocytoma. Conclusion: This case illustrates an unusual presentation of normotensive pheochromocytoma as adrenal incidentaloma. Pre-operative preparation in these patients can be achieved with alpha-adrenergic blockade, adequate hydration, and liberal salt intake.
- Subjects :
- medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Urinary system
Normotensive pheochromocytoma
adrenal incidentaloma
Brief Communication
Normetanephrine
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Surgical pathology
Pheochromocytoma
chemistry.chemical_compound
Endocrinology
medicine
lcsh:RC799-869
Salt intake
Metanephrine
lcsh:RC648-665
business.industry
medicine.disease
Surgery
Blockade
Blood pressure
chemistry
lcsh:Diseases of the digestive system. Gastroenterology
preoperative preparation
business
Subjects
Details
- ISSN :
- 22308210
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Indian Journal of Endocrinology and Metabolism
- Accession number :
- edsair.doi.dedup.....df1edc12d8482a5f8dd0cc0f6c11d8ca