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Ruptured Abdominal Aortic Aneurysm as the Initial Manifestation of Undiagnosed Pheochromocytoma
Kyotaro Fukuta1, Kohsuke Miyataka2, Yuya Hiroshima3
1Department of Urology Tokushima Prefectural Central Hospital Tokushima Japan.
Introduction:
Pheochromocytoma is a rare catecholamine-secreting tumor that can cause severe cardiovascular complications. Its association with ruptured abdominal aortic aneurysm is extremely rare.
Case Presentation:
A 57-year-old man with no significant medical history presented with sudden abdominal pain and hemorrhagic shock. Computed tomography revealed a ruptured infrarenal abdominal aortic aneurysm, and emergency endovascular aneurysm repair was successfully performed. Preoperative imaging incidentally detected a hypervascular left adrenal mass. Although biochemical findings were borderline, 123I-metaiodobenzylguanidine scintigraphy demonstrated intense uptake, leading to a diagnosis of pheochromocytoma. After appropriate α-adrenergic blockade, elective laparoscopic adrenalectomy was safely performed, and histopathology confirmed pheochromocytoma.
Conclusion:
This case highlights the importance of considering pheochromocytoma as an underlying cause of ruptured abdominal aortic aneurysm and demonstrates that a staged strategy with emergency endovascular repair followed by definitive endocrine surgery can be safe and effective.
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