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[Extra-adrenal pheochromocytoma. Report of a case]
F J Madrid García1, J A Rivas Escudero, L Parra Muntaner
1Servicio de Urología, Hospital del Bierzo, Ponferrada, León, España.
Objective:
To report a case of extraadrenal pheochromocytoma with special reference to the diagnostic and therapeutic aspects.
Methods:
A case of extraadrenal pheochromocytoma in a 20-year-old female with severe hypertension is presented. The clinical and biochemical aspects are reviewed with special reference to the diagnostic imaging methods.
Results:
Plasma noradrenaline and urinary normetanephrine levels were elevated. CT and MRI showed a well-defined mass, 6 cm in diameter, adjacent to the left kidney, abdominal aorta and psoas muscle. Angiography demonstrated a high vascularization in the area of the tumor. MIBG scintigraphy revealed a well-defined mass, but no other distant lesions. Surgical treatment was performed with preoperative alpha and beta adrenergic blockade. Currently the patient has a normal blood pressure and catecholamine levels, with no evidence of lesions on the MIBG scintiscan.
Conclusions:
Plasma catecholamine and urinary normetanephrine levels levels confirmed the presumptive diagnosis of pheochromocytoma. MIBG is the technique of choice for the localization of the mass and suspected metastases. CT, MRI and angiography demonstrated the anatomic relationships of the tumor. The best results are achieved with complete resection and preoperative adrenergic blockade.