Pheochromocytoma: an easily overlooked cause of secondary hypertension

Pheochromocytoma is a rare cause of secondary hypertension. Presentation varies from asymptomatic to paroxysmal hypertension, palpitations, flushing, syncope, and even shock or death. Diagnosis is often delayed because pheochromocytoma is not considered a likely diagnosis. We present the case of a 47-year-old male that presented with hypertensive emergency. Several diagnostic tests were performed prior to consideration of pheochromocytoma as the potential cause. Abdominal computed tomography revealed a nonspecific mass. A subsequent hormonal workup led to the diagnosis of pheochromocytoma. The patient underwent adrenalectomy seventeen days after presentation and postoperatively did well. This case demonstrates a typical presentation of pheochromocytoma and the need to consider pheochromocytoma early in the differential diagnosis of hypertensive emergency or difficult to control hypertension.