Dopamine- and norepinephrine-secreting intrapericardial pheochromocytoma in a normotensive patient

We have described a 41-year-old woman without hypertension in whom laboratory testing showed elevated urinary and plasma norepinephrine levels as well as increased plasma dopamine and enkephalin-like immunoreactivity. A pheochromocytoma was removed from the interatrial wall, but the course was complicated by intractable bleeding and the patient died. The atypical normotensive pheochromocytoma should be suspected in patients with insidious adrenergic symptoms when more routine diagnoses cannot be made.