Pheochromocytoma with renal artery compression in an identical twin

Kerzner, M. S.

doi:10.1001/archinte.121.1.91

Cited by 7 publications

(6 citation statements)

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“…RAS could be a cause of persistent hypertension in the postoperative period. [4] However, none of the patients in our cohort had persistent postoperative hypertension due to RAS alone. The only patient who had persistent hypertension underwent partial excision of PGL and had elevated plasma free metanephrines in the postoperative period.…”

Section: Discussionmentioning

confidence: 91%

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Coexistence of pheochromocytoma/praganglioma and renal artery stenosis

Sarathi

Bandgar

Lila

et al. 2012

Indian J Endocr Metab

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Renal artery stenosis (RAS) often coexists with pheochromocytoma (Pheo)/paraganglioma (PGL) and often alters the management of patients with Pheo/PGL. We have studied the prevalence of RAS in our Pheo/PGL patients. The study included 70 consecutive, histopathologically proven Pheo/PGL patients from a tertiary health care center. In 60 patients, tumors were limited to adrenal glands (54 unilateral and 6 bilateral) while other 10 patients had extra-adrenal abdominal tumors. Five patients had RAS with an overall prevalence of 14%. Only two out of 60 patients with Pheo had RAS with a low prevalence of 3.3% while three out of 10 patients with extra-adrenal abdominal PGL had RAS with a prevalence of 30%. To conclude, RAS commonly coexists with Pheo/PGL, more often with extra-adrenal PGL.

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Section: Discussionmentioning

confidence: 91%

“…Coexistence of RAS is often missed to get diagnosed only when evaluated for persistent hypertension postoperatively. [4] Coexistence of RAS alters the management and prognosis of Pheo/PGL patients. [2] Hence, identification of their coexistence before surgery is essential for the appropriate management.…”

Section: Introductionmentioning

confidence: 99%

Coexistence of pheochromocytoma/praganglioma and renal artery stenosis

Sarathi

Bandgar

Lila

et al. 2012

Indian J Endocr Metab

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“…It is significant that in five patients 1,4,5,15,17 out of twelvel-5, 15-18 with vascular changes induced by direct tumor compression and in one6 out of 4 patients6, 7, s, 2o with immediately adjacent but non-compressing tumors, the underlying pheochromocytoma was not appreciated pre-operatively despite angiography. It is even more significant that retrospective analysis of the arteriograms in these six cases revealed tumor vasculature about the stenosed segment of the renal artery in three instances.…”

Section: Discussionmentioning

confidence: 98%

“…It is even more significant that retrospective analysis of the arteriograms in these six cases revealed tumor vasculature about the stenosed segment of the renal artery in three instances. 1,4,6 FIG,48 (3) When pheochromocytoma and renal arterial disease are both present it should be possible to specify the nature of the vascular lesion by considering the location of the tumor, the site and configuration of the vascular lesion, and the presence or absence of previous surgery in the area. In the pre-operative period demonstration of a pheochromocytoma immediately adjacent to the renal artery suggests renal arterial stenosis secondary to direct tumor compression or, less likely, to catecholamine-induced spasm and/or stricture.…”

Section: Discussionmentioning

confidence: 99%

“…Most common has been a 0.5 to 2 cm smooth segmental stenosis of the distal half of the renal artery with a variable degree of post-stenotic dilatation.1, 3,4,18 Smooth tapering of the renal artery proximal to the stenosis,l stenosis of two separate branches of the renal artery,17 apparent arterial encasement,3, 4 and complete occlusion of the main renal artery with an irreguFzG. 2B lar stump15 have also been described.…”

Section: Classification Of Pheochromocytoma-related Renal Arterial DImentioning

confidence: 99%

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Renal Artery Alterations Associated with Pheochromocytoma

et al. 1972

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Pheochromocytoma may be associated with renal artery stenosis which con. tributes to the production of hypertension.l-11 This paper presents a classification of alterations in the renal artery associated with pheochromocytoma and discusses their significance. CASE REPORTIn 1969 a 22 year old white male presented to Montefiore Hospital with hypertension and ataxia. Historical review disclosed successful resections of large left and right para-adrenal pheochromocytomas in 1959 and 1960. Admission physical examination revealed blood pressure of 210/150, bilateral papilledema, and severe right-sided ataxia. Urinary levels of catecholamines and vanillyl mandelic acid (VMA) were elevated. Lumbar puncture revealed clear spinal fluid with opening pressure of 40 cm of water.Aortography and selective renal arteriography demonstrated a smoothly contoured segmental stenosis of the mid-portion of the right renal artery and a &dquo;tumor stain&dquo; superior to the renal artery indicating recurrent pheochromocytoma (Fig. 1). At surgery the right renal artery was found to be compressed by fibrous adhesions which produced a measured pressure gradient of 15 cm of water. The renal artery was dissected free of adhesions, but, despite extensive search, the tumor was not located. Post-operatively the patient did not resume spontaneous respiration and expired.Postmortem findings were (1) a small round well-encapsulated, extraadrenal pheochromocytoma extending posterior to the right adrenal gland and inferior vena cava; (2) a second two cm tumor nodule immediately adjacent to the right renal artery producing minimal compression; (3) slight residual right renal artery narrowing but otherwise normal kidneys and renal vasculature; (4) a 6 x 7 cm right cerebellar cyst, which contained a 1 cm mural nodule demonstrated microscopically to be a hemangioma; (5) compression of the 4th ventricle with mild hydrocephalus; (6) marked right tonsillar herniation with severe compression of the medulla; (7) normal adrenals, thyroid, parathyroids, liver, lungs and pancreas. COMMENTS This case illustrates the occurrence of renal artery compression by both a contiguous extra-adrenal tumor nodule of pheochromocytoma and by fibrous From the

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Regulation of Erythropoietin Production

Fisher

1992

Comprehensive Physiology

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The sections in this article are: Physicochemical Properties of Erythropoietin Assay and Standardization of Erythropoietin Model for Kidney Production of Erythropoietin Renal Site of Production of Erythropoietin Extrarenal Erythropoietin Production Sites of Action of Erythropoietin Anemia of Renal Insufficiency Erythropoietin and Polycythemia Pharmacological Agents that Influence Erythropoietin Production Pharmacokinetics of Erythropoietin Potential Therapeutic uses of Erythropoietin Summary

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Pheochromocytoma with renal artery compression in an identical twin

Cited by 7 publications

References 0 publications

Coexistence of pheochromocytoma/praganglioma and renal artery stenosis

Coexistence of pheochromocytoma/praganglioma and renal artery stenosis

Renal Artery Alterations Associated with Pheochromocytoma

Regulation of Erythropoietin Production

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