CASE OF PHEOCHROMOCYTOMA WITH PERMANENT HYPERTENSION

Pheochromocytoma is a tumor of chromaffin tissue that produces a large amount of biologically active substances (adrenaline, noradrenaline, dopamine), clinically manifested by hypertension and various metabolic disorders. Quite often the diagnosis is made only after autopsy. One of the reasons for l...

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Main Authors: E. V. Yakovleva, O. S. Lobanova, E. V. Zhukova, S. P. Eliseeva
Format: Article
Language:Russian
Published: SINAPS LLC 2019-07-01
Series:Архивъ внутренней медицины
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Online Access:https://www.medarhive.ru/jour/article/view/954
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author E. V. Yakovleva
O. S. Lobanova
E. V. Zhukova
S. P. Eliseeva
author_facet E. V. Yakovleva
O. S. Lobanova
E. V. Zhukova
S. P. Eliseeva
author_sort E. V. Yakovleva
collection DOAJ
description Pheochromocytoma is a tumor of chromaffin tissue that produces a large amount of biologically active substances (adrenaline, noradrenaline, dopamine), clinically manifested by hypertension and various metabolic disorders. Quite often the diagnosis is made only after autopsy. One of the reasons for late diagnosis is a great number of different clinical masks of the disease. Usually pheochromocytoma is suspected in patients with paroxysmal hypertension. We present a 37-year-old pregnant female (week 8 of pregnancy) with pheochromocytoma and permanent hypertension and sustained elevation of blood pressure up to 220/150 mm Hg. Her only complaint was vision disorder that started 3 months ago. Also, she noted a weight loss of 4 kg over the last 6 months. Retinopathy, left ventricle hypertrophy, tumor of right adrenal gland and glucose level disorders were revealed. Pregnancy was terminated for medical reasons. The patient took combination of doxazosin 0.4 mg, metoprolol 100 mg and moxonidin 0.4 mg per day and blood pressure was normalized to 130/90 mm Hg. Due to hypertension and tumor of right adrenal gland that are accompanied by retinopathy and metabolic disorders, pheochromocytoma was suspected. Contrast-enhanced computed tomography confirmed the tumor (60×73×70 mm) of right adrenal gland. Urinary normetanephrine level was 5.5 times higher than the norm. Magnetic resonance angiography of cerebral vessels was done because of malignant hypertension and family history (the patient’s sister had died of cerebral hemorrhage). Fusiform aneurysm of right internal carotid artery was revealed. The patient underwent laparoscopic resection of right adrenal gland. Histologic examination: pronounced cellular and nuclear polymorphism, invasion of tumor cells into a fibrous capsule, which does not exclude the malignant nature of pheochromocytoma. Follow-up period lasted for 8 months and was characterized by normalization of blood pressure, glucose level and weight gain of 3.5 kg. Computed tomography of retroperitoneal space and normal urinary metanephrine tests revealed no recurrent pheochromocytoma.
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spelling doaj-art-b93ed428cd914c0498a6849b9d4e772e2025-08-20T03:37:54ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642019-07-019431632210.20514/2226-6704-2019-9-4-316-322752CASE OF PHEOCHROMOCYTOMA WITH PERMANENT HYPERTENSIONE. V. Yakovleva0O. S. Lobanova1E. V. Zhukova2S. P. Eliseeva3State Educational Institution of Higher Professional Education «Saratov State Medical University n. a. V. I. Razumovsky» under the Ministry of Health of the Russian Federation, Hospital Therapy of Medical DepartmentState Educational Institution of Higher Professional Education «Saratov State Medical University n. a. V. I. Razumovsky» under the Ministry of Health of the Russian Federation, Hospital Therapy of Medical DepartmentSIH «Saratov Regional Clinical Hospital»SIH «Saratov Regional Clinical Hospital»Pheochromocytoma is a tumor of chromaffin tissue that produces a large amount of biologically active substances (adrenaline, noradrenaline, dopamine), clinically manifested by hypertension and various metabolic disorders. Quite often the diagnosis is made only after autopsy. One of the reasons for late diagnosis is a great number of different clinical masks of the disease. Usually pheochromocytoma is suspected in patients with paroxysmal hypertension. We present a 37-year-old pregnant female (week 8 of pregnancy) with pheochromocytoma and permanent hypertension and sustained elevation of blood pressure up to 220/150 mm Hg. Her only complaint was vision disorder that started 3 months ago. Also, she noted a weight loss of 4 kg over the last 6 months. Retinopathy, left ventricle hypertrophy, tumor of right adrenal gland and glucose level disorders were revealed. Pregnancy was terminated for medical reasons. The patient took combination of doxazosin 0.4 mg, metoprolol 100 mg and moxonidin 0.4 mg per day and blood pressure was normalized to 130/90 mm Hg. Due to hypertension and tumor of right adrenal gland that are accompanied by retinopathy and metabolic disorders, pheochromocytoma was suspected. Contrast-enhanced computed tomography confirmed the tumor (60×73×70 mm) of right adrenal gland. Urinary normetanephrine level was 5.5 times higher than the norm. Magnetic resonance angiography of cerebral vessels was done because of malignant hypertension and family history (the patient’s sister had died of cerebral hemorrhage). Fusiform aneurysm of right internal carotid artery was revealed. The patient underwent laparoscopic resection of right adrenal gland. Histologic examination: pronounced cellular and nuclear polymorphism, invasion of tumor cells into a fibrous capsule, which does not exclude the malignant nature of pheochromocytoma. Follow-up period lasted for 8 months and was characterized by normalization of blood pressure, glucose level and weight gain of 3.5 kg. Computed tomography of retroperitoneal space and normal urinary metanephrine tests revealed no recurrent pheochromocytoma.https://www.medarhive.ru/jour/article/view/954pheochromocytomahypertension
spellingShingle E. V. Yakovleva
O. S. Lobanova
E. V. Zhukova
S. P. Eliseeva
CASE OF PHEOCHROMOCYTOMA WITH PERMANENT HYPERTENSION
Архивъ внутренней медицины
pheochromocytoma
hypertension
title CASE OF PHEOCHROMOCYTOMA WITH PERMANENT HYPERTENSION
title_full CASE OF PHEOCHROMOCYTOMA WITH PERMANENT HYPERTENSION
title_fullStr CASE OF PHEOCHROMOCYTOMA WITH PERMANENT HYPERTENSION
title_full_unstemmed CASE OF PHEOCHROMOCYTOMA WITH PERMANENT HYPERTENSION
title_short CASE OF PHEOCHROMOCYTOMA WITH PERMANENT HYPERTENSION
title_sort case of pheochromocytoma with permanent hypertension
topic pheochromocytoma
hypertension
url https://www.medarhive.ru/jour/article/view/954
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AT oslobanova caseofpheochromocytomawithpermanenthypertension
AT evzhukova caseofpheochromocytomawithpermanenthypertension
AT speliseeva caseofpheochromocytomawithpermanenthypertension