Phaeochromocytoma in a 86-year-old patient presenting with reversible myocardial dysfunction
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Published on: July 18, 2014
Elżbieta Szwench1, Mariola P Czkowska, Krzysztof Marczewski
1Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
Insights
Phaeochromocytoma, a rare tumor, can affect elderly patients and cause reversible heart dysfunction. Surgical removal of the tumor led to improved heart function in an 86-year-old patient.
Area of Science:
- Endocrinology
- Cardiology
- Oncology
Background:
- Phaeochromocytomas and paragangliomas are rare catecholamine-producing tumors originating from chromaffin cells.
- These tumors typically occur in middle-aged adults, with rare instances in the very elderly.
- They are a cause of secondary hypertension.
Observation:
- An 86-year-old patient presented with phaeochromocytoma and reversible myocardial dysfunction.
- The patient exhibited hypertension with labile blood pressure and increased variability.
- Symptoms suggested catecholamine-induced cardiomyopathy.
Findings:
- Surgical resection of the phaeochromocytoma was performed.
- Echocardiography post-surgery demonstrated normalization of systolic function.
- Improvement in diastolic function was also observed after tumor removal.
Implications:
- Phaeochromocytoma should be considered in the differential diagnosis of hypertension, irrespective of patient age.
- This case highlights the potential for reversible cardiac complications in elderly patients with phaeochromocytoma.
- Early diagnosis and treatment are crucial for managing secondary hypertension and associated cardiac dysfunction.
Abstract:
BACKGROUND. Phaeochromocytomas and paragangliomas are rare, mostly benign catecholamine-producing tumours of chromaffin cells of the adrenal medulla or of extra-adrenal paraganglia. Phaeochromocytoma may occur at any age, the greatest frequency being in the fourth and fifth decades. Only on extremely rare occasions does the tumour develop in the very old patients. METHODS. We are describing an 86-year-old patient with phaeochromocytoma, presenting with reversible myocardial dysfunction. RESULTS. This very old patient with phaeochromocytoma had hypertension characterized by labile blood pressure values and increased daytime blood pressure variability. This patient exhibited reversible myocardial dysfunction suggestive for "catecholaminergic cardiomyopathy", as the complication of phaeochromocytoma. After surgical removal of the tumour, recovery of left ventricular function was documented by echocardiography showing normalization of systolic function and improvement of diastolic function. CONCLUSION. Phaeochromocytomas are rare forms of secondary hypertension, but should be considered in the differential diagnosis, regardless of age, even in very old patients.
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