Pheochromocytoma in an elderly patient (case report)

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Background: Timely diagnosis of pheochromocytoma (PCC) is difficult due to the rare occurrence of this pathology (1:200,000 population) and variability of clinical symptoms. One of the manifestations of PCC is arterial hypertension (AH), which can be either paroxysmal in nature or manifest as persistent AH resistant to antihypertensive therapy.

Description of the clinical case: The article considers the clinical case of an elderly patient who, despite typical complaints for FCC and therapy-resistant hypertension, was followed-up for a long time with a diagnosis of arterial hypertension (AH). This led to uncontrolled hypertension and the development of acute cerebrovascular accident (ACVA). For the first time, the diagnosis of FCC was suspected during the treatment of COVID-19 after chest multispiral computed tomography (chest MSCT) and the detection of a formation in the left adrenal gland. Surgical removal of FCC led to normalization of blood pressure (BP) in the postoperative period without taking any antihypertensive drugs.

Conclusion: The presented clinical case shows the importance of the earliest possible diagnosis of FCC in patients with therapy-resistant hypertension in order to avoid the development of serious complications, including ACVA. The article summarizes the current recommendations for the diagnosis of pheochromocytoma, which suggest the determination of blood or urine methylated catecholamine levels (metanephrine, normetanephrine) as specific markers of this disease as first-line diagnostic tests.

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Sobre autores

L. Khamnueva

Irkutsk State Medical University

Email: gryaznova_81@inbox.ru
ORCID ID: 0000-0001-6296-898X
Código SPIN: 4933-3080

Department of Endocrinology and Clinical Pharmacology

Rússia, Irkutsk

L. Andreeva

Irkutsk State Medical University

Email: gryaznova_81@inbox.ru
ORCID ID: 0000-0003-4687-0004
Código SPIN: 2221-7452

Department of Endocrinology and Clinical Pharmacology

Rússia, Irkutsk

Maria Gryaznova

Irkutsk State Medical University

Autor responsável pela correspondência
Email: gryaznova_81@inbox.ru
ORCID ID: 0009-0007-6631-6138
Código SPIN: 9760-9435

Cand. Sci. (Med.), Teaching Assistant, Department of Endocrinology and Clinical Pharmacology

Rússia, Irkutsk

E. Danilova

Irkutsk Order of the Badge of Honor Regional Clinical Hospital

Email: gryaznova_81@inbox.ru
Rússia, Irkutsk

A. Basayeva

Irkutsk State Medical University

Email: gryaznova_81@inbox.ru

Department of Endocrinology and Clinical Pharmacology

Rússia, Irkutsk

Bibliografia

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2. Figure 1. Space-occupying lesion of the left adrenal gland according to multispiral computed tomography data

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3. Figure 2. Space-occupying lesion of the left adrenal gland according to multispiral computed tomography data

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4. Figure 3. Microscopic specimen: histological picture of pheochromocytoma with moderate polymorphism, no necrosis, no invasion into the vessel wall

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