Pheochromocytoma without hypertension

Pheochromocytoma is a rare tumour which is usually suggested by sustained or paroxysmal hypertension. Our patient with a pheochromocytoma was unusual for two reasons: she was normotensive during 3 weeks of close observation in the hospital and the urinary adrenaline level was higher than the noradrenaline level. In the patient's history there were no data on hypertension attacks. The patient had a palpable abdominal mass and the cytological finding was in contrast with a clinical diagnosis of pheochromocytoma. The surgery revealed a tumour and the pathohistologic evaluation established the diagnosis of pheochromocytoma. After surgery, the patient's urinary catecholamine levels reverted to normal. Our patient may have been normotensive because her tumour predominantly secreted adrenaline and perhaps other vasodilating substances.