[Pheochromocytoma associated with cholelithiasis]

Pheochromocytoma is an adrenal or extra-adrenal tumor, which produces and secretes catecholamines. It is a rare cause of hypertension. Hypertension or hypertensive crises are most frequent clinical manifestations. Sometimes it can be associated with other diseases and conditions, such as cholelithiasis.

We present a 37-year-old woman admitted to hospital with gastrointestinal complaints (right upper abdominal pain, nausea, vomiting) and hypertension with occasional hypertensive crises. Routine abdominal ultrasound revealed a gall-bladder stone, and enlargement of the right adrenal gland. The diagnosis of pheochromocytoma was confirmed by measurement of catecholamine levels in 24-hour urine collection and MIBG scan. After preoperative preparation, tumor extirpation was done. Histology confirmed the diagnosis of pheochromocytoma. Routine controls of catecholamine 24-hour urine levels showed no catecholamine excess, without hypertension and hypertensive crises as most frequent clinical manifestations.

Physicians must consider pheochromocytomas in cases of drug resistant hypertension or hypertensive crises. Sometimes pheochromocytomas are associated with other diseases, such as gall-bladder stones, with mimicking and overlapping of clinical manifestations of pheochromocytomas with symptoms and signs of the associated disease.