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Medical Science Monitor Basic Research


A diagnostically difficult case of recurrent multiple extraadrenal pheochromocytoma in a patient with long-term history of essential hypertension

Beata Krasińska, Andrzej Tykarski, Zbigniew Krasiński, Jerzy Głuszek

CaseRepClinPractRev 2003; 4(1):53-56

ID: 429028

Available online:


Background: The case of a 50-year-old female with hypertension is reported. Two years after the diagnosis of hypertension, the patient developed complications such as myocardial infarction and stroke. Problems encountered during diagnostics and treatment, as well as the atypical course of the disease caused by multiple pheochromocytoma induced the authors to present the case. Case Report: Computed tomography performed because of acute abdominal pains revealed tumors in the retroperitoneal space, which were removed during exploratory laparotomy. Pheochromocytoma was diagnosed by histopathology. The level of vanilyl-mandelic acid determined after the surgery was still increased. Another single tumor was detected in color MIBG scanning. It was removed during the second operation. After the second surgery, normalization of laboratory results was obtained. A year later, the patient underwent surgery once again because of recurrence of symptoms and the presence of a new tumor in the retroperitoneal space. Despite the operation, the level of catecholamines has increased again. Conclusions: The reported case represented almost all atypical features of the clinical presentation of pheochromocytoma. The above clinical case leads to the following conclusions: 1. Pheochromocytoma should be excluded in cases of hypertension with atypical course. 2. Radical surgical treatment of multiple pheochromocytoma is difficult and should be preceded by MIBG scanning in each case to increase its effectiveness. 3. The history of recurrent pheochromocytoma should provide an indication for periodic postoperative monitoring of available biochemical parameters, even during the periods of clinical remission

Keywords: Hypertension, Pheochromocytoma, tumor, Retroperitoneal Space