Ruptured Abdominal Aortic Aneurysm with a Suprarenal Tumor

Arıkan, Ali Ahmet

doi:10.21470/1678-9741-2017-0166

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…It has been theorized that the presence of pheochromocytoma increases the risk of AAA development and rupture [3,8]. Concurrent presentation has included in an asymptomatic fashion, as in our case, with rupture, and with "occult" pheochromocytoma which required post AAA repair study and resection [7][8][9][10]. When possible, ideally the adrenal tumor should be resected prior to AAA repair, with alpha-blockade, as even biochemically "inert" tumors can prompt hypertensive crisis [4,10].…”

Section: Resultsmentioning

confidence: 93%

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Abdominal Aortic Aneurysm and Pheochromocytoma

Reese¹,

Feliciano²,

Karmy‐Jones³

et al. 2019

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Simultaneous presentation of pheochromocytoma and abdominal aortic aneurysm (AAA) is uncommon and poses unique challenges. Based on the rare case reports, there may be an association with AAA development and rupture. The approach to these separate lesions requires medical management to prevent hypertensive crisis and cardiovascular collapse, decision whether to approach the pheochromocytoma laparoscopically or by open approaches, the decision to approach the AAA by open or endovascular repair (EVAR) and the sequence and timing of repair. We present a case of a female who had a biochemically active but clinical benign pheochromocytoma in conjunction with an AAA that was repaired simultaneously by an open approach

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Section: Resultsmentioning

confidence: 93%

“…When possible, ideally the adrenal tumor should be resected prior to AAA repair, with alpha-blockade, as even biochemically "inert" tumors can prompt hypertensive crisis [4,10]. However, sometimes the sequence is reversed [8,9].…”

Section: Resultsmentioning

confidence: 99%

Abdominal Aortic Aneurysm and Pheochromocytoma

Reese¹,

Feliciano²,

Karmy‐Jones³

et al. 2019

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“…Finally, interestingly enough, several case reports have described the coexistence of pheochromocytoma and other neuroendocrine tumors with aortic dissections and aneurysm rupture supporting that TH pathway hyperactivity might contribute to aneurysm development and eventually aortic rupture in these patients. 53,54 Furthermore, high TH and both overall and regional aortic sympathetic nervous system activities have been documented in patients with thoracic aortic dissection. 5 Our study evidences for the first time that the upregulation of the TH pathway could be critical in the pathophysiology of AAA, both in humans and animal experimental models, and supports the therapeutic potential of approaches based on targeting this pathway for the medical management of AAA.…”

Section: Discussionmentioning

confidence: 99%

Targeting Tyrosine Hydroxylase for Abdominal Aortic Aneurysm: Impact on Inflammation, Oxidative Stress, and Vascular Remodeling

et al. 2021

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Pharmacological treatments for preventing abdominal aortic aneurysm (AAA) rupture or slowing aneurysm progression remain a challenge. It is increasingly recognized that sympathetic activity might play a role in the pathogenesis of AAA; however, the impact of this pathway remains unclear. Here, we show that the expression of tyrosine hydroxylase ( TH ), dopamine β-hydroxylase ( DBH ), and the norepinephrine transporter SLC6A2 is upregulated in abdominal aorta samples from AAA patients and in the aneurysmal aorta from 2 animal models susceptible to Ang II (angiotensin II)–induced AAA: the apolipoprotein E-deficient (ApoE −/− ) model and a transgenic mouse that overexpresses the human nuclear receptor NOR-1 (neuron-derived orphan receptor-1) in the vascular wall (TgNOR-1 VSMC ). TH localizes to sympathetic nerves innervating the local vasculature, but also to inflammatory cells, and scattered vascular smooth muscle cell in human and mouse AAA. Interestingly, the preventive effect of doxycycline on AAA formation in Ang II–treated TgNOR-1 VSMC mice was associated to the normalization of vascular Th expression. Moreover, the TH specific inhibitor α-methyl- p -tyrosine protected against Ang II–induced AAA formation, limiting the progressive increase in aortic diameter without affecting blood pressure. The drug normalized MMP2 (matrix metalloproteinase 2) expression and MMP activity, preserving elastin integrity, attenuated the Ang II–mediated rise in vascular oxidative stress and inflammatory markers and reduced the inflammatory infiltrate. Finally, NOR-1, whose expression correlated with that of TH in human AAA, was able to drive human TH transcriptional activity in transient transfection assays. Therefore, the upregulation of the TH pathway could be critical in the pathophysiology of AAA, supporting the potential of pharmacological strategies targeting TH for AAA management.

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“…In two cases, ruptured AAA repair was complicated by intra-operative and post-operative blood pressure derangements with subsequent diagnosis of pheochromocytoma. 11,12 Thompson et al. 13 described the diagnosis of a pheochromocytoma with MIBG imaging after a repaired AAA began leaking.…”

Section: Discussionmentioning

confidence: 99%

Open abdominal aortic aneurysm repair with incidental finding of an extra-adrenal pheochromocytoma of the organ of Zuckerkandl

Gonzalez

Singh

2020

Vascular

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Objectives Pheochromocytomas are rare catecholamine-secreting neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla or extra-adrenal paraganglia. The most common location of these tumors is within the adrenal medulla. Extra-adrenal pheochromocytomas (EAPs) may occur in any portion of the paraganglion system. The most common location of EAPs is at the organ of Zuckerkandl, which is a collection of chromaffin cells near the origin of the inferior mesenteric artery. Methods We present a case of an EAP of the organ of Zuckerkandl incidentally discovered and resected during urgent open repair of a symptomatic 6.7-cm juxtarenal abdominal aortic aneurysm (AAA). Results The patient underwent successful open surgical repair of a juxtarenal AAA and resection of the pheochromocytoma. Conclusions Concomitant pheochromocytomas and abdominal aortic aneurysms are rare, with a small number described in the literature. We describe the case of a simultaneous EAP of the organ of Zuckerkandl and AAA repair. This case demonstrates that these lesions can be safely resected in the same setting as AAA repair.

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Ruptured Abdominal Aortic Aneurysm with a Suprarenal Tumor

Cited by 3 publications

References 5 publications

Abdominal Aortic Aneurysm and Pheochromocytoma

Abdominal Aortic Aneurysm and Pheochromocytoma

Targeting Tyrosine Hydroxylase for Abdominal Aortic Aneurysm: Impact on Inflammation, Oxidative Stress, and Vascular Remodeling

Open abdominal aortic aneurysm repair with incidental finding of an extra-adrenal pheochromocytoma of the organ of Zuckerkandl

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