An unusual diagnosis for persistent diarrhoea and vomiting

Area of Science:

• Endocrinology
• Gastroenterology
• Oncology

Background:

• Chronic diarrhea and vomiting present diagnostic challenges, causing significant patient distress.
• Unexplained gastrointestinal symptoms can lead to prolonged periods of uncertainty and impaired quality of life.

Purpose of the Study:

• To highlight a rare cause of chronic diarrhea and vomiting.
• To illustrate the diagnostic process for a retroperitoneal mass presenting with gastrointestinal symptoms.

Main Methods:

• Case report of a 45-year-old female with a 5-year history of cyclical diarrhea, vomiting, abdominal pain, and palpitations.
• Diagnostic workup included contrast CT Abdomen/Pelvis and plasma metanephrine level measurement.
• Surgical resection of the retroperitoneal mass followed by histological confirmation.

Main Results:

• CT revealed a 36x33x46 mm retroperitoneal mass.
• Elevated plasma metanephrine level (2314 pmol/L) indicated a likely pheochromocytoma.
• Histology confirmed the diagnosis of pheochromocytoma.
• Surgical resection resulted in rapid symptom resolution and full recovery.

Conclusions:

• Pheochromocytoma is an unusual but important cause of chronic, cyclical gastrointestinal upset.
• A high index of suspicion and targeted investigations are crucial for diagnosing rare conditions presenting with common symptoms.
• This case underscores the importance of considering endocrine and oncological etiologies in refractory gastrointestinal disorders.