Case Report
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Akut koroner sendromu taklit eden dev feokromositoma olgusu

Year 2020, Volume: 3 Issue: 4, 479 - 482, 22.10.2020
https://doi.org/10.32322/jhsm.747791

Abstract

References

  • Widimský J. Recent advances in the diagnosis and treatment of pheochromocytoma. Kidney Blood Press Res 2006; 29: 321–6.
  • Melson E, Amir S, Shepherd L, Kauser S, Freestone B, Kempegowda P. Myocardial Infarction with non-obstructed coronaries-atypical presentation of pheochromocytoma. Endocrinol Diabetes Metab Case Rep 2019; 2019.
  • Guerrero MA, Schreinemakers JMJ, Vriens MR, et al. Clinical spectrum of pheochromocytoma. J Am Coll Surg 2009; 209: 727–32.
  • Maharaj R, Parbhu S, Ramcharan W, et al. Giant cystic pheochromocytoma with low risk of malignancy: a case report and literature review. Case Rep Oncol Med 2017; 2017: 4638608.
  • Beard CM, Sheps SG, Kurland LT, Carney JA, Lie JT. Occurrence of pheochromocytoma in Rochester, Minnesota, 1950 through 1979. Mayo Clin Proc 1983; 58: 802–4.
  • Ambati D, Jana K, Domes T. Largest pheochromocytoma reported in Canada: A case study and literature review. Can Urol Assoc J 2014; 8: E374-7.
  • Reisch N, Peczkowska M, Januszewicz A, Neumann HPH. Pheochromocytoma: presentation, diagnosis and treatment. J Hypertens 2006; 24: 2331–9.
  • Goldstein RE, O’Neill JA, Holcomb GW, et al. Clinical experience over 48 years with pheochromocytoma. Ann Surg 1999; 229: 755–64.
  • Yu R, Nissen NN, Chopra P, Dhall D, Phillips E, Wei M. Diagnosis and treatment of pheochromocytoma in an academic hospital from 1997 to 2007. Am J Med 2009; 122: 85–95.
  • Bravo EL, Gifford RW. Pheochromocytoma. Endocrinol Metab Clin North Am 1993; 22: 329–41.
  • Bravo EL. Pheochromocytoma: new concepts and future trends. Kidney Int 1991; 40: 544–56.
  • Komamura K, Fukui M, Iwasaku T, Hirotani S, Masuyama T. Takotsubo cardiomyopathy: Pathophysiology, diagnosis and treatment. World J Cardiol 2014; 6: 602–9.
  • Lenders JWM, Duh Q-Y, Eisenhofer G, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99: 1915–42.
  • Eisenhofer G, Rivers G, Rosas AL, Quezado Z, Manger WM, Pacak K. Adverse drug reactions in patients with phaeochromocytoma: incidence, prevention and management. Drug Saf 2007; 30: 1031–62.
  • Alexandraki KI, Grossman AB. Adrenal incidentalomas: “the rule of four.” Clin Med (Lond) 2008; 8: 201–4.
  • Arnaldi G, Boscaro M. Adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab 2012; 26: 405–19.
  • Ichijo T, Ueshiba H, Nawata H, Yanase T. A nationwide survey of adrenal incidentalomas in Japan: the first report of clinical and epidemiological features. Endocr J 2020; 67: 141-52. doi: 10.1507/endocrj.EJ18-0486
  • Korgali E, Dundar G, Gokce G, et al. Giant malignant pheochromocytoma with palpable rib metastases. Case Rep Urol 2014; 2014: 354687.
  • Uysal E, Kırdak T, Gürer AO, İkidağ MA. Giant multicystic malignant pheochromocytoma. Turk J Surg 2015; 33: 296–8.
  • Soufi M, Lahlou MK, Benamr S, et al. Giant malignant cystic pheochromocytoma: a case report. Indian J Surg 2012; 74: 504–6.
  • Agarwal V, Kant G, Hans N, Messerli FH. Takotsubo-like cardiomyopathy in pheochromocytoma. Int J Cardiol 2011; 153: 241–8.
  • Paulin FL, Klein GJ, Gula LJ, Skanes AC, Yee R, Krahn AD. QT prolongation and monomorphic VT caused by pheochromocytoma. J Cardiovasc Electrophysiol 2009; 20: 931–4.

Cardiac presentations mimicking acute coronary syndrome of a giant pheochromocytoma case

Year 2020, Volume: 3 Issue: 4, 479 - 482, 22.10.2020
https://doi.org/10.32322/jhsm.747791

Abstract

Pheochromocytomas are benign tumors which originate from adrenal chromaffin cells. The classical triad of the pheochromocytoma includes headache, palpitations, and diaphoresis. Cardiac complications as arrhythmias, cardiomyopathy, ST elevated myocardial infarction, non-ST elevated myocardial infarction and myocardial infarction with non-obstructive coronary arteries (MINOCA) may be seen.
Herein, we present a case of a 28-year-old male patient who admitted to an emergency department with chest pain and tachycardia one year ago. Coronary angiography was performed to diagnose a possible acute coronary syndrome. Urgent cardiac catheterization did not demonstrate an obstructive cardiac artery. Any intervention for revascularization was not needed. Nevertheless, the symptoms of the patient continued in the past year after this admission and he was admitted to the hospital a few times more with similar cardiac symptoms mimicking acute coronary syndrome. When the patient referred to our department, we determined that his plasma and urinary catecholamine levels were elevated. Magnetic resonance imaging (MRI) demonstrated a 167x70 mm sized heterogeneous mass including cystic components in the right adrenal gland, which pushes the right kidney towards inferior. After the pre-medication, a 170 mm in size 990-g weighted mass was successfully removed with open surgery. Histopathological findings confirmed the pheochromocytoma diagnosis. However, we presented a case of an exceptional giant pheochromocytoma mimicking acute coronary syndrome.

References

  • Widimský J. Recent advances in the diagnosis and treatment of pheochromocytoma. Kidney Blood Press Res 2006; 29: 321–6.
  • Melson E, Amir S, Shepherd L, Kauser S, Freestone B, Kempegowda P. Myocardial Infarction with non-obstructed coronaries-atypical presentation of pheochromocytoma. Endocrinol Diabetes Metab Case Rep 2019; 2019.
  • Guerrero MA, Schreinemakers JMJ, Vriens MR, et al. Clinical spectrum of pheochromocytoma. J Am Coll Surg 2009; 209: 727–32.
  • Maharaj R, Parbhu S, Ramcharan W, et al. Giant cystic pheochromocytoma with low risk of malignancy: a case report and literature review. Case Rep Oncol Med 2017; 2017: 4638608.
  • Beard CM, Sheps SG, Kurland LT, Carney JA, Lie JT. Occurrence of pheochromocytoma in Rochester, Minnesota, 1950 through 1979. Mayo Clin Proc 1983; 58: 802–4.
  • Ambati D, Jana K, Domes T. Largest pheochromocytoma reported in Canada: A case study and literature review. Can Urol Assoc J 2014; 8: E374-7.
  • Reisch N, Peczkowska M, Januszewicz A, Neumann HPH. Pheochromocytoma: presentation, diagnosis and treatment. J Hypertens 2006; 24: 2331–9.
  • Goldstein RE, O’Neill JA, Holcomb GW, et al. Clinical experience over 48 years with pheochromocytoma. Ann Surg 1999; 229: 755–64.
  • Yu R, Nissen NN, Chopra P, Dhall D, Phillips E, Wei M. Diagnosis and treatment of pheochromocytoma in an academic hospital from 1997 to 2007. Am J Med 2009; 122: 85–95.
  • Bravo EL, Gifford RW. Pheochromocytoma. Endocrinol Metab Clin North Am 1993; 22: 329–41.
  • Bravo EL. Pheochromocytoma: new concepts and future trends. Kidney Int 1991; 40: 544–56.
  • Komamura K, Fukui M, Iwasaku T, Hirotani S, Masuyama T. Takotsubo cardiomyopathy: Pathophysiology, diagnosis and treatment. World J Cardiol 2014; 6: 602–9.
  • Lenders JWM, Duh Q-Y, Eisenhofer G, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99: 1915–42.
  • Eisenhofer G, Rivers G, Rosas AL, Quezado Z, Manger WM, Pacak K. Adverse drug reactions in patients with phaeochromocytoma: incidence, prevention and management. Drug Saf 2007; 30: 1031–62.
  • Alexandraki KI, Grossman AB. Adrenal incidentalomas: “the rule of four.” Clin Med (Lond) 2008; 8: 201–4.
  • Arnaldi G, Boscaro M. Adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab 2012; 26: 405–19.
  • Ichijo T, Ueshiba H, Nawata H, Yanase T. A nationwide survey of adrenal incidentalomas in Japan: the first report of clinical and epidemiological features. Endocr J 2020; 67: 141-52. doi: 10.1507/endocrj.EJ18-0486
  • Korgali E, Dundar G, Gokce G, et al. Giant malignant pheochromocytoma with palpable rib metastases. Case Rep Urol 2014; 2014: 354687.
  • Uysal E, Kırdak T, Gürer AO, İkidağ MA. Giant multicystic malignant pheochromocytoma. Turk J Surg 2015; 33: 296–8.
  • Soufi M, Lahlou MK, Benamr S, et al. Giant malignant cystic pheochromocytoma: a case report. Indian J Surg 2012; 74: 504–6.
  • Agarwal V, Kant G, Hans N, Messerli FH. Takotsubo-like cardiomyopathy in pheochromocytoma. Int J Cardiol 2011; 153: 241–8.
  • Paulin FL, Klein GJ, Gula LJ, Skanes AC, Yee R, Krahn AD. QT prolongation and monomorphic VT caused by pheochromocytoma. J Cardiovasc Electrophysiol 2009; 20: 931–4.
There are 22 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Report
Authors

Pınar Akhanlı

Bekir Ucan

Ahmet Hasdemir This is me 0000-0001-8540-1935

Sema Hepşen This is me 0000-0002-8375-7409

İlknur Öztürk Ünsal

Mehmet Ali Felekoğlu This is me 0000-0001-7991-5139

Erman Çakal

Publication Date October 22, 2020
Published in Issue Year 2020 Volume: 3 Issue: 4

Cite

AMA Akhanlı P, Ucan B, Hasdemir A, Hepşen S, Öztürk Ünsal İ, Felekoğlu MA, Çakal E. Cardiac presentations mimicking acute coronary syndrome of a giant pheochromocytoma case. J Health Sci Med / JHSM. October 2020;3(4):479-482. doi:10.32322/jhsm.747791

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