[Erythema nodosum becoming a pheochromocytoma]

The erythema nodosum is a septal panniculitis of several etiologies: infectious, medicamentous, secondary to systemic disease or idiopathic cause. The patient is a 47 year-female with a hypertension history of several years of evolution, who shows the following set of symptoms: successive rashes of erythematous and pruriginous cutaneous lesions in inferior members, which are diagnosed by a cutaneous biopsy of erythema nodosum. In the etiology study, an abdominal echographia is made, finding a hypodense 7 x 5 cm solid mass placed in the left adrenal gland. Determinations of catecholamines and their metabolites are found to be increased in plasma and urine, with a final diagnosis of pheochromocytoma. The pheochromocytoma is an adrenal marrow tumour of chromaffin cells derived of the neural crest, which secrete catecholamines. It is an unusual tumour, with no gender differences and with a higher incidence between the third and fourth decade of life. Ninety per cent of the cases are rather sporadic. It causes arterial hypertension just in the 0.1 and 0.2% of total cases. The appearance of erythema nodosum as one more symptom in the evolutionary context of a pheochromocytoma is a relation poorly documented in the examined literature. We could think it is just a possible coincidence, as searching with Medline we just find out one international bibliographic reference.