背景嗜铬细胞瘤,肾上腺髓质罕见肿瘤,可以表现出高度多变的症状;因此,嗜铬细胞瘤经常未被诊断,留下潜在的生理并发症。绝对,这些并发症包括嗜铬细胞瘤危象,其中释放高水平的儿茶酚胺并导致危及生命的高血压紧急情况。随着时间的推移,未确诊的嗜铬细胞瘤可导致与长期暴露于高血压相关的心血管损害和终末器官疾病。案例报告我们分享一例45岁女性嗜铬细胞瘤的案例,该女性表现为顽固性恶心的胃肠道症状,呕吐,和腹痛。影像学显示肾上腺肿块具有与骨髓脂肪瘤最一致的影像学特征。在患者接受麻醉和内窥镜检查以进一步诊断胃肠道症状之前,这可以引发嗜铬细胞瘤患者的儿茶酚胺激增,进行了进一步的生化检测.血浆和尿液检测证实嗜铬细胞瘤,并进行手术切除以进行确定性治疗。最终,切除肿瘤后,患者的症状得到了缓解。结论手术切除后症状的缓解表明,症状可能与肿瘤的质量效应有关,或者是儿茶酚胺水平升高的非典型表现。此外,通过筛查嗜铬细胞瘤,患者能够避免常见的胃肠病诊断程序可能导致的潜在并发症。该病例报告强调了当面对可能是非特异性或与周围器官的质量效应有关的症状时,筛查嗜铬细胞瘤的潜在益处。
BACKGROUND Pheochromocytomas, rare tumors arising from the adrenal medulla, can present with highly variable symptoms; therefore, pheochromocytomas frequently remain undiagnosed, leaving the potential for physiological complications. Acutely, these complications include
pheochromocytoma crisis, in which high levels of catecholamines are released and cause a life-threatening hypertensive emergency. Over time, undiagnosed pheochromocytomas can lead to cardiovascular damage and end-organ disease related to chronic exposure to elevated blood pressure. CASE REPORT We share a case of
pheochromocytoma in a 45-year-old woman who presented with gastrointestinal symptoms of intractable nausea, vomiting, and abdominal pain. Imaging revealed an adrenal mass that had radiographic features that were most consistent with myelolipoma. Before exposing the patient to anesthesia and endoscopy for further diagnostic workup of her gastrointestinal symptoms, which can trigger a catecholamine surge in individuals with a pheochromocytoma, further biochemical testing was performed. Testing of plasma and urine confirmed
pheochromocytoma, and surgical resection was performed for definitive treatment. Ultimately, the patient had resolution of her symptoms following the removal of the tumor. CONCLUSIONS The resolution of symptoms following surgical resection suggests that symptoms may have been related to the mass effect of the tumor or as an atypical manifestation of increased catecholamine levels. Additionally, by screening for
pheochromocytoma, the patient was able to avoid potential complications that can result from common gastroenterological diagnostic procedures. This case report highlights the potential benefit for screening for
pheochromocytoma when faced with symptoms that may be non-specific or related to mass effect upon surrounding organs.