A large pheochromocytoma requiring aortic and inferior vena caval reconstruction: A case report

Rationale: It is difficult to discriminate malignant pheochromocytoma (PCC) from benign PCC. The requirement of abdominal aortic and inferior vena cava reconstruction is extremely rare. Patient concerns: We here report a case of a large pheochromocytoma in a 56-year-old woman who complained of only hand trembling and had no hypertension or other symptoms. The operation was difficult because of a tight adhesion to the circumference of great vessels. A replacement of the aortocaval vessels with grafts was necessary to remove the tumor completely. Diagnoses: Ultrasonography, computed tomography (CT), and catecholamine assay revealed suspecting the retroperitoneal PCC. Interventions: Tumor excision and reconstruction of the abdominal aorta and inferior vena cava by externally supported polytetrafluoroethylene (ePTFE) vessels were successfully performed. Outcomes: A follow-up CT angiography showed no recurrence and graft vessels presented good patency after 7years. Catecholamine in urine and serum assay was normal. Lessons: The complete resection of the tumor and infiltrated great vessels were necessary for the long-term survival of patients with a large PCC. The ePTFE graft is a good substitute for vessel reconstruction.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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Conclusion: Congenital polycythemia was clinically diagnosed, mimicking Chuvash polycythemia. Chuvash polycythemia is an autosomal recessive disorder that usually harbors a homozygous mutation of VHL598C>T but not predispose to pheochromocytoma development; in contrast our patient showed for the first time that the concurrent heterozygous VHL and TMEM mutations, resulted in a clinical phenotype of a normotensive patient with polycythemia due to erythropoietin-secreting pheochromocytoma that improved after adrenalectomy.
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS: Secondary hypertension Source Type: research
Authors: Teragaki M, Yamamoto T, Hosomi K, Tada Y, Maeda K, Nishiya D, Miyazaki C, Takagi Y, Sakanoue Y, Nishida Y, Okuno H, Tsuiki M, Naruse M Abstract A 46-year-old woman complained of a 10-year history of headache, nausea, a precordial oppressive feeling and shortness of breath on miction. She had noted a marked elevation in her blood pressure after miction using home blood pressure measurement. Her catecholamine levels were less than twice the value of the normal upper limit. Several imaging modalities detected a urinary bladder tumor, and 123I- metaiodobenzylguanidine (MIBG) scintigraphy showed positive accumu...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
AbstractPurpose of reviewHypertension is one of the most common conditions encountered in the primary care setting, affecting 32 –46% of people. While essential or primary hypertension is the most common form of the disease, secondary hypertension is quite prevalent, occurring in 10–20% of patients with hypertension. Accurately diagnosing secondary hypertension is a challenging and often time-consuming process that requir es considerable expertise and effort. However, once the secondary etiology is identified, the patient benefits profoundly from a potentially curative treatment that may lead to significant imp...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
ConclusionsA delay in diagnosis or lack of a diagnosis in pheochromocytoma and paraganglioma may increase the perioperative morbidity and mortality risk due to excess catecholamine secretion. Therefore, routine pheochromocytoma and paraganglioma screening preoperatively in patients with neurofibromatosis type 1 is very important.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
By HANS DUVEFELT, MD In medicine, contrary to common belief, it is not usually enough to know the diagnosis and its best treatment or procedure. Guidelines, checklists and protocols only go so far when you are treating real people with diverse constitutions for multiple problems under a variety of circumstances. The more you know about unusual presentations of common diseases, the more likely you are to make the correct diagnosis, I think everyone would agree. Also, the more you know about the rare diseases that can look like the common one you think you’re seeing in front if you, rather than having just a memo...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Physicians Primary Care Hans Duvefelt primary care physicians Source Type: blogs
A 52-year-old male who had chronic hypertension for several years presented with abrupt epistaxis. The CT scan revealed a 40 mm × 40 mm mass in the nasal cavity intended to the maxillary sinus and the base of skull. Nasal endoscope biopsy and serum/urinary catecholamine detection conformed an ectopic noradrenaline-secreting pheochromocytoma. The present research was to discuss the clinical characteristics of the rare pheochromocytoma and the palliative interventional embolization for it.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
This article summarizes current clinical approaches in patients with pheochromocytoma/paraganglioma.
Source: Endocrinology and Metabolism Clinics of North America - Category: Endocrinology Authors: Source Type: research
CONCLUSIONS: Imaging, symptomatic and laboratory response to multimodal treatment including high dose 131 I-MIBG were achieved on long-term follow up in metastatic pheochromocytoma or paraganglioma. Imaging response at 3-6 months was prognostic. PMID: 31614368 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Endocrinology and Metabolism - Category: Endocrinology Authors: Tags: J Clin Endocrinol Metab Source Type: research
ConclusionPheochromocytomas is a rare disease which may lead to a life-threathening hypertension as a result of elevated cathecolamine production. Initial recognition and appropriate management of pheochromocytomas are important. Preoperative management to normalize blood pressure followed by tumor removal has proved to be the ideal choice for good prognosis. Multidisciplinary team during preoperative, intraoperative and postoperative are required for successful outcome.
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
AbstractPurpose of ReviewThe present paper will review the results of experimental and clinical studies aimed at defining the functional behavior of the central and peripheral nervous system in adrenal pheochromocytoma.Recent FindingsThe contribution of sympathetic neural influences to the development of high blood pressure values in pheochromocytoma is complex. Studies performed in experimental animal models have shown that hypertension and the concomitant high circulating levels of catecholamines can lead to inhibition of central sympathetic neural outflow by reflex mechanisms and direct stimulation of central adrenergic...
Source: Current Hypertension Reports - Category: Primary Care Source Type: research
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