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Pheochromocytoma multisystem crisis. A surgical emergency
K A Newell1, R A Prinz, J Pickleman
1Department of Surgery, Loyola University, Maywood, Ill 60153.
Archives of Surgery (Chicago, Ill. : 1960)
|August 1, 1988
Summary
Pheochromocytoma multisystem crisis (PMC) is a rare, severe condition characterized by organ failure and high fever. Prompt diagnosis and emergency surgery are crucial for survival in these critical cases.
Area of Science:
- Endocrinology
- Nephrology
- Critical Care Medicine
Background:
- Pheochromocytoma is a rare neuroendocrine tumor.
- Pheochromocytoma multisystem crisis (PMC) is an unusual and severe presentation.
Observation:
- Three of 27 patients presented with PMC, a condition involving multiple organ system failure.
- Key features included high fever (>40°C), encephalopathy, and significant blood pressure fluctuations (hypertension/hypotension).
Findings:
- Medical management controlled blood pressure but failed to halt PMC progression.
- Two patients improved after urgent adrenalectomy, while one patient died during septic focus localization.
- Large tumors with markedly elevated epinephrine levels were observed in all PMC cases.
Implications:
- PMC requires prompt diagnosis and aggressive medical preparation.
- Emergency adrenalectomy is indicated for patients with deteriorating conditions.
- Increased epinephrine secretion is a potential cause of PMC.