Undiagnosed pheochromocytoma presenting as a pancreatic tumor: A case report
Autor: | Ryszard Pogorzelski, Z Galazka, Ewa Krajewska, Krzysztof Celejewski, Małgorzata Legocka, Sadegh Toutounchi |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
adrenal tumor medicine.medical_specialty endocrine system endocrine system diseases medicine.medical_treatment laparoscopy abdominal tumor Pheochromocytoma 03 medical and health sciences 0302 clinical medicine intraoperative management Pancreatic tumor hypertensive crisis medicine Doxazosin Laparoscopy medicine.diagnostic_test Adrenal gland business.industry Adrenalectomy adrenalectomy General Medicine medicine.disease pheochromocytoma Discontinuation Surgery 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Medicine Differential diagnosis business medicine.drug Research Article |
Zdroj: | Open Medicine, Vol 15, Iss 1, Pp 103-106 (2020) Open Medicine |
ISSN: | 2391-5463 |
Popis: | Pheochromocytoma is a rare catecholamine-producing tumor of the adrenal gland. Patients with known pheochromocytoma undergoing surgery require preoperative treatment with alpha-blockers to reduce the risk of intraoperative complications related to catecholamine release. If undiagnosed, pheochromocytoma can lead to life-threatening surgical complications. We report the case of a patient with a suspected solid pseudopapillary neoplasm in the pancreatic tail, for whom pancreatoduodenectomy was scheduled. However, shortly after abdominal incision, hypertensive crisis developed and was followed by severe hypotension requiring intravenous vasopressors, which prompted discontinuation of the operation. Further diagnostic evaluation revealed marked elevations in urinary excretion of methylated catecholamines and suggested that the tumor was in fact a pheochromocytoma extending from the left adrenal gland. After preoperative treatment with doxazosin, the patient underwent lateral transperitoneal laparoscopic adrenalectomy, with no major complications and an uneventful postoperative course. The pathological report confirmed a diagnosis of pheochromocytoma. Due to the potential for life-threatening surgical complications in patients with pheochromocytoma not treated preoperatively with alpha-blockers, this tumor type should be included in the differential diagnosis of abdominal tumors of unknown origin. |
Databáze: | OpenAIRE |
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