Hemorrhagic shock due to spontaneous rupture of adrenal pheochromocytoma

Bittencourt, J. A.; Averbeck, Márcio Augusto; Schmitz, Herbert J.

doi:10.1590/s1677-55382003000500007

Cited by 8 publications

(5 citation statements)

References 3 publications

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“…Acute haemorrhagic rupture is extremely rare as the initial manifestation of a pheochromocytoma. Other clinical features and symptoms such as sudden-onset haemodynamic collapse or flank pain as with our case had also been reported [1][2][3][4][5][6][7]. In general, it is difficult to diagnose pheochromocytoma after rupture due to the following reasons.…”

Section: Discussionsupporting

confidence: 64%

Vanishing of ruptured adrenal mass with takotsubo cardiomyopathy

2018

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A 45-year-old male suddenly experienced left-flank abdominal pain. Echocardiography revealed akinesis of the 'takotsubo cardiomyopathy' type. He experienced a sudden haemodynamic collapse (blood pressure, 324/154 mmHg; pulse rate, 180 beats/min) during emergency cardiac catheterisation. An abdominal computed tomography (CT) revealed expansion of a soft tissue mass 64 × 33 mm in dimension in the left adrenal region, with accumulation of fluid surrounding the left pararenal space. Three days after the attack, his urinary catecholamine concentrations were slightly elevated. We suspected the patient as having a pheochromocytoma followed by acute haemorrhagic rupture, based on signatures of adrenal mass, 'takotsubo cardiomyopathy', and the hypertensive crisis. Over the next few weeks, he recovered well as an outpatient, and his blood pressure remained around 110/60 mmHg without medication. Three weeks after the attack, an abdominal CT showed shrinkage of the ruptured adrenal mass (to a diameter of 30 mm) and absorption of the retroperitoneal hematoma. On day 190 after the attack, abdominal CT did not detect any left adrenal mass. This is the first report of the case showing a complete vanishing of ruptured adrenal mass with takotsubo cardiomyopathy. Although surgical approaches for ruptured adrenal mass involve either emergency or elective surgery, the patients did not need even the elective surgery. Accumulation of the similar cases may unravel clinical factors predicting self-limiting of the ruptured adrenal mass to avoid unnecessary risky surgery.

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Section: Discussionsupporting

confidence: 64%

Vanishing of ruptured adrenal mass with takotsubo cardiomyopathy

2018

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“…[4] Most patients with spontaneous rupture of pheochromocytoma are admitted to the hospital due to acute abdominal pain. In majority of cases, the bleeding occurs in the retroperitonium; however, some may bleed both in the retroperitonium and peritoneal cavity,[5] such as in the present case. The exact mechanism of a pheochromocytoma rupture is unknown, but a high intracapsular pressure may tear the capsule and also cause necrosis of the tumor.…”

Section: Discussionmentioning

confidence: 78%

Spontaneous rupture of adrenal pheochromocytoma in a patient with Von Recklinghausen′s disease

Azhough

Barband

Motayagheni

et al. 2009

Indian Journal of Critical Care Medicine

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Spontaneous rupture of an adrenal pheochromocytoma is extremely rare and can be lethal because of dramatic changes in the circulation. We describe a 35-year-old Iranian female with previously diagnosed von Recklinghausen's disease who suffered spontaneous rupture of an adrenal pheochromocytoma, misdiagnosed as renal colic followed by an extensive retroperitoneal hematoma, irreversible hemodynamic shock, and death.

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“…Whatever the clinical picture in the foreground, computed tomography (CT) scanning of the abdomen is still the most useful examination for diagnosis [27]. It showed a heterogeneous mass and hematoma in the suprarenal region of retro-peritoneum [6].…”

Section: Discussionmentioning

confidence: 99%

Catastrophic hemorrhage of adrenal pheochromocytoma following thrombolysis for acute myocardial infarction: case report and literature review

et al. 2014

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We describe here the case of a 62-year-old man with acute abdominal syndrome and severe hemorrhagic shock following successful thrombolysis for acute cardiac infarction. Emergency surgical exploration revealed extensive intraperitoneal and retroperitoneal hemorrhage resulting from the rupture of a large adrenal tumor. The diagnosis of pheochromocytoma was confirmed by histological findings. The patient died a few hours after surgery from multiorgan failure despite resuscitation attempts. This report discusses the diagnosis difficulties, treatment approach, and relevant literature.

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Hemorrhagic shock due to spontaneous rupture of adrenal pheochromocytoma

Cited by 8 publications

References 3 publications

Vanishing of ruptured adrenal mass with takotsubo cardiomyopathy

Vanishing of ruptured adrenal mass with takotsubo cardiomyopathy

Spontaneous rupture of adrenal pheochromocytoma in a patient with Von Recklinghausen′s disease

Catastrophic hemorrhage of adrenal pheochromocytoma following thrombolysis for acute myocardial infarction: case report and literature review

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