Abstract：
BACKGROUND: Pheochromocytomas are rare tumors of the adrenal gland. Intestinal pseudo-obstruction is a very rare presentation of a functioning catecholamine-secreting tumor. We present a case of intestinal pseudo-obstruction due to a large functioning pheochromocytoma.
METHODS: A 29-year-old female presented with abdominal distension, pain, nausea, and vomiting with constipation for 3 weeks. She was hypertensive and diabetic and was on multiple medications. She reported frequent spells of severe headaches, palpitations, night sweats, and a 17 kg weight loss over 6 months. She had pallor, dyspnea, marked abdominal distension, and diminished bowel sounds. Her blood pressure was high at 200/120 mmHg. She had tachycardia (pulse 120 bpm) and tachypnea (35 pm). Serum metanephrine levels were significantly elevated, measuring 1203 pg/ml. Abdominal CT showed a heterogeneous, hyper-vascular mass near the upper pole of the left kidney, measuring 10.75 cm × 8.72 cm. Open left adrenalectomy was performed through an anterior subcostal approach to remove the tumor with the left adrenal gland. Histopathological examinations were consistent with pheochromocytoma.
CONCLUSIONS: Some authors documented the correlation between tumor size and metabolic activity of catecholamine-secreting tumors with intestinal pseudo-obstruction by paralytic ileus. This case corresponds with these findings, with a tumor mass of 350 g and a serum metanephrine level of 1203 pg/ml.
CONCLUSIONS: Although it is extremely rare, functioning pheochomocytoma could be a cause of instestinal obstruction or pseudo-obstruction.
METHODS: A 29-year-old female presented with abdominal distension, pain, nausea, and vomiting with constipation for 3 weeks. She was hypertensive and diabetic and was on multiple medications. She reported frequent spells of severe headaches, palpitations, night sweats, and a 17 kg weight loss over 6 months. She had pallor, dyspnea, marked abdominal distension, and diminished bowel sounds. Her blood pressure was high at 200/120 mmHg. She had tachycardia (pulse 120 bpm) and tachypnea (35 pm). Serum metanephrine levels were significantly elevated, measuring 1203 pg/ml. Abdominal CT showed a heterogeneous, hyper-vascular mass near the upper pole of the left kidney, measuring 10.75 cm × 8.72 cm. Open left adrenalectomy was performed through an anterior subcostal approach to remove the tumor with the left adrenal gland. Histopathological examinations were consistent with pheochromocytoma.
CONCLUSIONS: Some authors documented the correlation between tumor size and metabolic activity of catecholamine-secreting tumors with intestinal pseudo-obstruction by paralytic ileus. This case corresponds with these findings, with a tumor mass of 350 g and a serum metanephrine level of 1203 pg/ml.
CONCLUSIONS: Although it is extremely rare, functioning pheochomocytoma could be a cause of instestinal obstruction or pseudo-obstruction.
摘要：
背景：嗜铬细胞瘤是一种罕见的肾上腺肿瘤。肠道假性梗阻是分泌儿茶酚胺的功能性肿瘤的非常罕见的表现。我们介绍了一例由于大型功能性嗜铬细胞瘤引起的假性肠梗阻。
方法：一名29岁女性出现腹胀，疼痛,恶心,呕吐，便秘3周。她患有高血压和糖尿病，正在服用多种药物。她报告说经常有严重的头痛，心悸,盗汗,和17公斤的体重减轻超过6个月。她脸色苍白，呼吸困难,明显的腹胀,肠鸣音减弱.她的血压高达200/120mmHg。她有心动过速（脉搏120bpm）和呼吸急促（35pm）。血清间肾上腺素水平显著升高，测量1203pg/ml。腹部CT显示异质性，左肾上极附近的高血管肿块，测量10.75厘米×8.72厘米。通过前肋下入路进行开放的左肾上腺切除术，以切除带有左肾上腺的肿瘤。组织病理学检查与嗜铬细胞瘤一致。
结论：一些作者记录了儿茶酚胺分泌型肿瘤与麻痹性肠梗阻假性梗阻的肿瘤大小和代谢活性之间的相关性。这个案例与这些发现相对应，肿瘤质量为350g，血清间肾上腺素水平为1203pg/ml。
结论：虽然极为罕见，功能性嗜铬细胞瘤可能是椎管内梗阻或假性梗阻的原因。
方法：一名29岁女性出现腹胀，疼痛,恶心,呕吐，便秘3周。她患有高血压和糖尿病，正在服用多种药物。她报告说经常有严重的头痛，心悸,盗汗,和17公斤的体重减轻超过6个月。她脸色苍白，呼吸困难,明显的腹胀,肠鸣音减弱.她的血压高达200/120mmHg。她有心动过速（脉搏120bpm）和呼吸急促（35pm）。血清间肾上腺素水平显著升高，测量1203pg/ml。腹部CT显示异质性，左肾上极附近的高血管肿块，测量10.75厘米×8.72厘米。通过前肋下入路进行开放的左肾上腺切除术，以切除带有左肾上腺的肿瘤。组织病理学检查与嗜铬细胞瘤一致。
结论：一些作者记录了儿茶酚胺分泌型肿瘤与麻痹性肠梗阻假性梗阻的肿瘤大小和代谢活性之间的相关性。这个案例与这些发现相对应，肿瘤质量为350g，血清间肾上腺素水平为1203pg/ml。
结论：虽然极为罕见，功能性嗜铬细胞瘤可能是椎管内梗阻或假性梗阻的原因。
