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[Pheochromocytoma in children. Two case reports]
H Zerhouni1, N Kaddouri, M Abdelhak
1Clinique chirurgicale infantile A, hôpital d'enfants, CHU Ibn Sina, Rabat, Maroc. hzerhouni@hotmail.com
Insights
Pheochromocytoma is a rare cause of severe hypertension in children. Early diagnosis and surgical removal of these adrenal tumors can normalize blood pressure in pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Pediatric Oncology
- Nephrology
Background:
- Severe sustained hypertension is rare in children, with endocrine causes accounting for only 2% of cases.
- Pheochromocytoma, a catecholamine-secreting tumor, is an exceedingly rare cause of severe hypertension in the pediatric population.
Observation:
- Two 12-year-old boys presented with sustained hypertension, headache, sweating, and visual blurring.
- Diagnostic evaluation revealed elevated 24-hour urinary catecholamines and unilateral adrenal pheochromocytoma confirmed by ultrasonography and computed tomography.
Findings:
- Surgical excision of the adrenal pheochromocytoma was performed using a transverse transperitoneal approach.
- Post-operative normalization of blood pressure was observed in both patients, indicating successful tumor removal.
Implications:
- Highlights the importance of a high index of suspicion for pheochromocytoma in children presenting with severe hypertension.
- Demonstrates the effectiveness of prompt diagnosis and surgical intervention in managing pediatric pheochromocytoma.
- Emphasizes the need for awareness of the clinical spectrum of pheochromocytoma to ensure timely diagnosis and treatment.
Abstract:
Severe sustained hypertension occurs in only 0.1% of the pediatric population and only about 2% of these patients will have an underlying endocrine cause. Pheochromocytoma as a catecholamine secreting tumour causing severe hypertension is exceedingly rare in children. A high index of suspicion and an awareness of the clinical spectrum are therefore necessary to make the diagnosis. We report two cases of pheochromocytoma occurring in two a 12 year-old boys who's presented with sustained hypertension, headache, sweating, and visual blurring. Measurement of 24 hour urinary catecholamines showed a marked increase and localization of adrenal unilateral pheochromocytoma was determined by ultrasonography and computed tomography. The approaches to the adrenal gland were transverse transperitoneal and the excision of the tumors was followed of return to the normal of tensional numbers.