Introduction: Pheochromocytomas are secreting tumors, producing catecholamines (dopamine, noradrenaline and adrenaline), responsible for arterial hypertension; Pheochromocytoma in the diabetic may be responsible for an unbalanced glycemic and this considerably modifies the management. We present the case of a patient for whom the diagnosis of pheochromocytoma was posed before a glycemic imbalance.
Clinical case: A 70-year-old patient is hospitalized for unexplained unstable diabetes mellitus (Several episodes of severe hypo-hyperglycaemia per week with a 7.5% Hba1c. It is diabetes mellitus evolving for 20 years, marked by instability of glycemic figures For 3 years, during his hospitalization for management of severe hypertension was discovered associated with headache and slimming.Infectious and inflammatory balance without anomaly, no lipodystrophy, in search of endocrinopathy responsible for this hypertension and unstable diabetes Biological assays: chromogranin at 10 times normal and Metanephrine at 3.33 times normal, abdomino-pelvic ultrasound finds a supra-renal mass supplemented by pelvic CT recovering an oval tissue formation measuring 46.8×36.5 mm Enhancing intensely after injection of contrast medium, evoke a pheochromocytoma confirmed by a MIBG scintigraphy which finds a focus of intense hyperfixation of the tracer radio corresponding to a right adrenal neurectodermal tumor of 52×36 mm. In search of other pathologies coming within the framework of a multiple endocrine neoplasia the assessment of extension is without anomaly. Patient is programmed in surgery for a management
Conclusion: In patients with pheochromocytoma 35% are diabetic, the diagnosis of pheochromocytoma in the diabetic may be responsible for a glycemic imbalance and this considerably alters the management.
20 - 23 May 2017
European Society of Endocrinology