A14945 Ectopic adrenal pheochromocytoma: A case report

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To understand the diversity of pheochromocytoma


A 35-year-old woman with a pancreatic tumor detected during a medical checkup was admitted for surgery. She had not a history of high blood pressure and any discomfort. The physical examination and laboratory results were normal.During the surgery, the blood pressure of this patient increased rapidly, and decreased subsequently. Oxygen pressure declined obviously after the operation, and physical examination showed bilateral lung wet rale. ECG:sinus tachycardia and T wave inversion (figure).Chest X-ray:bilateral pulmonary exudative lesions and enlargement of the cardiac silhouette. UCG:regional wall motion abnormalities of left ventricular involving the segments of inferior, mid anteroseptal and apical anterior, LVEF 36% (Simpson).The change of blood pressure andlaboratory results were shown in table.


The pathologic result showed ectopic adrenal pheochromocytoma. About 5 days after therapy pulmonary exudative lesions disappeared, 11days UCG showed ventricular wall motion returned to normal. Asymptomatic pheochromocytoma accounts for about 8% of adrenal pheochromocytoma. Ectopic adrenal pheochromocytoma is relatively rare, especially in the pancreas. The lack of clinical manifestations and the typical imaging changes brought certain difficulties to diagnosis. Characteristics of this case are conform to the Takotsubo syndrome, including the following: 1)acute left heart failure after operation, 2) TNI rose moderately, 3) BNP increased significantly, 4) ECG: T wave inversion, 5) UCG: segmental ventricular wall motion abnormalities beyond the territory of single coronary arte


As a rare case, detail and professional analysis of it can undoubtedly deepen our understanding of the diversity of pheochromocytoma and Takotsubo syndrom

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