Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

Brouwers, Frederieke M.; Eisenhofer, Graeme; Lenders, Jacques W.M.; Pacák, Karel

doi:10.1016/j.ecl.2006.09.014

Cited by 62 publications

(43 citation statements)

References 210 publications

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“…In previous cases, abdominal pain and constipation have been due to acute events including megacolon [16][17] or paralytic ileus [18] and pseudo-obstruction [19][20]. Other causes include pancratitis, cholecystitis or perforation and bleeding [21][22][23]. Similar to other cases, our case was in the upper age group and had gastrointestinal symptoms accompanied by weight loss.…”

Section: Discussionsupporting

confidence: 60%

Bilateral Pheochromocytoma Presenting with Only Gastrointestinal Complaints: A Case Report

Norouzi¹,

Fazel²,

Tavassoli³

et al. 2017

jcbr

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Introduction: Pheochromocytoma is a rare catecholamine-secreting tumor with gastrointestinal manifestations. Case description: Herein, we report a 50 years old female patient with abdominal pain, altered bowel habit, abdominal mass lesion and laboratory features of pheochromocytoma. The patient was admitted with abdominal pain, back pain, arthralgia, weakness, lethargy, cold sweat and weight loss. She had history of diabetes mellitus, ischemic heart disease and hyperlipidemia. On admission, she was normotensive and had normal physical examination. Upper and lower endoscopies were normal. Transabdominal sonography and CT scan showed large heterogeneous masses with central necrosis and calcification in adrenal regions. In addition, 24-hour urine evaluation showed elevated vanillylmandelic acid, metanephrine and normetanephrine levels. She underwent bilateral adrenalectomy. Pathologic evaluation showed typical characteristics of pheochromocytoma. Conclusions: In any patient with abdominal pain and abdominal mass, low threshold for diagnosis of rare but often lethal pheochromocytoma is suggested.

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Section: Discussionsupporting

confidence: 60%

Bilateral Pheochromocytoma Presenting with Only Gastrointestinal Complaints: A Case Report

Norouzi¹,

Fazel²,

Tavassoli³

et al. 2017

jcbr

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“…The prevalence of pheochromocytomas in patients with hypertension is in the range of 0.6% (7). Pheochromocytomas can also present with life-threatening complications resulting in acute end organ damage (8,9).…”

Section: Introductionmentioning

confidence: 99%

Life-threatening events in patients with pheochromocytoma

Riester

Weismann

Quinkler

et al. 2015

European Journal of Endocrinology

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Objective: Pheochromocytomas are rare chromaffin cell-derived tumors causing paroxysmal episodes of headache, palpitation, sweating and hypertension. Life-threatening complications have been described in case reports and small series. Systematic analyses are not available. We took an opportunity of a large series to make a survey. Design and methods: We analyzed records of patients diagnosed with pheochromocytomas in three geographically spread German referral centers between 2003 and 2012 (nZ135). Results: Eleven percent of the patients (ten women, five men) required in-hospital treatment on intensive care units (ICUs) due to complications caused by unsuspected pheochromocytomas. The main reasons for ICU admission were acute catecholamine induced Tako-Tsubo cardiomyopathy (nZ4), myocardial infarction (nZ2), acute pulmonary edema (nZ2), cerebrovascular stroke (nZ2), ischemic ileus (nZ1), acute renal failure (nZ2), and multi organ failure (nZ1). One patient required extracorporeal membrane oxygenation due to a hypertensive crisis with lung edema occurring during delivery (nZ1). Two patients died of refractory shock and pheochromocytomas were found postmortem. Two patients were treated by emergency surgery. Compared to pheochromocytoma patients without life-threatening events (nZ120), patients with complications had a significant larger maximal tumor diameter (7.0 vs 4.5 cm, P!0.01), higher levels of catecholamines (20-vs ninefold upper limit of normal, P!0.01), and tended to be younger (42 vs 51 years, PZ0.05). Conclusion: Although pheochromocytomas are rare, they are likely to be associated with a life-threatening situation. Clinicians have to be aware of these situations and perform a timely diagnosis.

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“…Most of adrenal ganglioneuroma do not have endocrine function, it was reported there are 20%-30% of the tumors can secrete testosterone, catecholamines and its metabolites by some research [2][3][4]. The adrenal imaging is the helpful measures for its diagnosis and differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Ganglioneuroma: A Rare Case Report and Literature Review

Bentao¹

2017

UNOAJ

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Submit Manuscript | http://medcraveonline.com hyperaldosteronism, hypertension and hypercortisolism. Further examination was taken in our hospital. The contrast-enhanced CT identified a quasi-circular nodular lesion in the right adrenal gland, measuring 6x6.5cm and displaying heterogeneous with mottling and spotty dense calcification on the edge of the mass. The margin of lesion was clear and presented 46 HU in plain scan and 68-113 HU in the enhancement. The tumor surrounded the right renal vein and part of postcava, but didn't narrow the vessels (Figure 1). All of functional laboratory evolution showed negative including blood testing for catecholamines (epinephrine and norepinephrine) and their metabolites (metanephrine in serum and VMA in a 24-hour urine sample), free cortisol and ACTH (adrenocorticotropic hormone) in serum and plasma testing for renin-angiotensin-aldosterone under recumbent and upright state. A laparoscopic right adrenalectomy was performed ( Figure 2) and postoperative pathology revealed a right ganglioneuroma. Immunohistochemistry showed S-100, CD56, Syn and CgA staining are positive (Figure 3 & 4). After one year follow-up, the patient has not had any local recurrence and distant metastasis. AbstractBackground: Adrenal ganglioneuroma is a rare sympathetic tumor which originated from adrenal medulla [1]. Multi slice spiral CT and 3d reconstruction have gradually been considered as one of the most important technical for discovery and identification of the incidentalomas. However, the accurate diagnosis of this tumor remains a challenge due to its nonspecific clinic and radiological performance. This report presents the clinic and radiological data for the infrequent tumor which should share some experience to facilitate the criteria for the diagnosis of adrenal ganglioneuroma.

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Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

Cited by 62 publications

References 210 publications

Bilateral Pheochromocytoma Presenting with Only Gastrointestinal Complaints: A Case Report

Bilateral Pheochromocytoma Presenting with Only Gastrointestinal Complaints: A Case Report

Life-threatening events in patients with pheochromocytoma

Adrenal Ganglioneuroma: A Rare Case Report and Literature Review

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