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Published on: July 4, 2013
Pheochromocytoma-induced aggression?
Sinan Altiner1, Gregory Dodell, Jean Abed
1Department of Internal Medicine, Columbia University School of Physicians and Surgeons, New York, New York, USA. saltiner@chpnet.org
Summary
This case study highlights a pheochromocytoma with high norepinephrine to epinephrine ratios linked to aggressive behavior. Surgical removal of the tumor may not immediately alter behavior due to prolonged catecholamine exposure.
Area of Science:
- Endocrinology
- Neuroscience
- Oncology
Background:
- Pheochromocytoma, a rare adrenal tumor, can secrete excessive catecholamines.
- Elevated norepinephrine to epinephrine (NE:E) ratios have been anecdotally linked to aggressive behavior.
Observation:
- A 33-year-old male presented with palpitations, chest pain, and hypertension.
- Imaging revealed a right adrenal mass; plasma NE:E ratio was 35, and urinary normetanephrine to metanephrine ratio exceeded 26.
- Histopathology confirmed a benign pheochromocytoma, surgically resected.
Findings:
- The patient exhibited a significantly high plasma NE:E ratio and urinary normetanephrine to metanephrine ratio.
- Post-surgery, catecholamine levels may remain elevated for up to a week.
- Behavioral changes were not immediately apparent after tumor removal.
Implications:
- Norepinephrine-predominant pheochromocytoma may contribute to violent and aggressive behavior.
- Conditioning from prolonged high norepinephrine levels could influence behavior even after tumor removal.
- Further research is needed to understand the catecholamine-behavior relationship in pheochromocytoma.
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