Endocrine Abstracts

Introduction: Pheochromocytoma is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure. The clinical manifestations of patients with pheochromocytoma are diverse, ranging from asymptomatic, paroxysmal hypertension, episodic anxiety to devastating acute heart failure and acute pulmonary edema, which all increase the difficulty of identifying and diagnosing it.

Case presentation: We report the case of a 51-year-old man, with a 4-year history of resistant arterial hypertension, type 2 diabetes mellitus, and post-ischemic stroke. The patient complaints abdominal pain in the right iliac fossa, which is suspected as acute appendicitis, complicated with hypertensive crisis, headache and sweating. Abdominal ultrasound shows a round hypoechoic formation, 29 mm, in the superior pole of right kidney. Computed tomography scan of abdomen shows a dense formation in the right suprarenal gland, 30 x 30 mm, with densification of the surrounding tissue, suspicions for pheochromocytoma. Laboratory tests revealed elevated urinary metanephrine excretion of 1030 mg/24 hours (rate <375 mg/24 hours) and elevated urinary normetanephrine of 835 mg/24 hours (rate <780 mg/24 hours. Open surgical excision of the pheochromocytoma was performed. The histological analysis of the mass confirmed diagnosis. The symptoms releated to pheochromocytoma were relieved and the blood pressure returned to normal after surgery.

Conclusion: Pheocromocytoma is a rare tumor of the adrenal gland that is responsible for a small percentage of all patients with hypertension. However, it should always be suspected in patients with resistant and unstable hypertension.