UNUSUAL CASE OF UNCONTROLLED HYPERTENTION

Dr. Saurabh Boralkar

Abstract


Pheochromocytomas rare neuroendocrine tumors that arise from chromaffin-cells in the adrenal medulla. Pheochromocytomas have an estimated
prevalence of up to 5% of adults presenting with adrenal incidentalomas.
Reported is a case of a 54 Year old patient admitted with, Excessive sweating and giddiness for 20 days,Lower urinary tract symptoms for 15 days,
LAB INVESTIGATIONS showed: NorepinephrineLevel:2690 picogram/ml, Metanephrine level:1276 picogram/ml, 24 hour VMA
level:16.8mg/24 hours, Sr. Cortisol level:0.4 Microgram/DeciLitre .On examination Blood pressure was raised. Rest examination was normal.
RBS-234mg/dl. USG(A+P) -consistent with Pheocromocytoma .CT scan revealed ? Pheocromocytoma. PET Scan showed left supra-renal mass
compatible with Pheocromocytoma. Preoperatively the patient was given Alpha and Beta blockers for 7 days Intraop the patient was on
phenoxibenzamine drip.Laparoscopic left adrenalectomy was performed. Postoperatively;B.P and RBS was normal.


Keywords


Pheocromocytoma, Neuroendocrine Tumor, Metanephrines, Norepinephrine

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References


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Guerrero MA, SchreinemakersJM, Vriens MR, SuhI, HwangJ, ShenWT, et al. Clinical spectrum of pheochromocytoma J Am Coll Surg 2009;209:727

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