Extra-adrenal pheochromocytoma with initial symptom of haemoptysis: a case report and review of literature.


Journal

BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567

Informations de publication

Date de publication:
06 Jan 2021
Historique:
received: 02 08 2020
accepted: 27 12 2020
entrez: 7 1 2021
pubmed: 8 1 2021
medline: 3 2 2021
Statut: epublish

Résumé

Pheochromocytoma is a catecholamine-secreting tumour that leads to various symptoms. Haemoptysis is rarely caused by a pheochromocytoma occurring outside the bronchus or thoracic cavity. Here, we report the case of an extra-adrenal abdominal pheochromocytoma initially manifesting as haemoptysis/dyspnoea during exercise without classic symptoms. A 22-year-old man with a history of severe dyspnoea experienced difficulties in breathing following a marathon owing to haemoptysis that required ventilator management 1 year before presentation. His father had undergone surgery for ectopic pheochromocytoma. Computed tomography (CT) revealed a 30-mm tumour between the inferior vena cava and pancreatic head while urinalysis revealed abnormally high noradrenaline levels. He was clinically diagnosed with an extra-adrenal abdominal ectopic pheochromocytoma. After controlling blood pressure, surgery was performed, and the tumour was successfully removed. Histopathology revealed chromogranin A (+), synaptophysin (+), S100 protein (+), and MIB-1 index of 1%. Therefore, the patient was finally diagnosed with extra-adrenal abdominal ectopic pheochromocytoma. Haemoptysis is a rare manifestation of abdominal ectopic paraganglioma. Prompt consideration of pheochromocytoma/paraganglioma when patients experience haemoptysis without any other possible aetiology may prevent inappropriate diagnosis and treatment and ultimately fatalities.

Sections du résumé

BACKGROUND BACKGROUND
Pheochromocytoma is a catecholamine-secreting tumour that leads to various symptoms. Haemoptysis is rarely caused by a pheochromocytoma occurring outside the bronchus or thoracic cavity. Here, we report the case of an extra-adrenal abdominal pheochromocytoma initially manifesting as haemoptysis/dyspnoea during exercise without classic symptoms.
CASE PRESENTATION METHODS
A 22-year-old man with a history of severe dyspnoea experienced difficulties in breathing following a marathon owing to haemoptysis that required ventilator management 1 year before presentation. His father had undergone surgery for ectopic pheochromocytoma. Computed tomography (CT) revealed a 30-mm tumour between the inferior vena cava and pancreatic head while urinalysis revealed abnormally high noradrenaline levels. He was clinically diagnosed with an extra-adrenal abdominal ectopic pheochromocytoma. After controlling blood pressure, surgery was performed, and the tumour was successfully removed. Histopathology revealed chromogranin A (+), synaptophysin (+), S100 protein (+), and MIB-1 index of 1%. Therefore, the patient was finally diagnosed with extra-adrenal abdominal ectopic pheochromocytoma.
CONCLUSIONS CONCLUSIONS
Haemoptysis is a rare manifestation of abdominal ectopic paraganglioma. Prompt consideration of pheochromocytoma/paraganglioma when patients experience haemoptysis without any other possible aetiology may prevent inappropriate diagnosis and treatment and ultimately fatalities.

Identifiants

pubmed: 33407379
doi: 10.1186/s12893-020-01038-6
pii: 10.1186/s12893-020-01038-6
pmc: PMC7789603
doi:

Types de publication

Case Reports Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

13

Références

J Clin Hypertens. 1986 Mar;2(1):65-7
pubmed: 3723160
J Clin Endocrinol Metab. 2001 Nov;86(11):5210-6
pubmed: 11701678
Clin Endocrinol (Oxf). 2013 Feb;78(2):165-75
pubmed: 23061808
Horm Metab Res. 2019 Jul;51(7):458-469
pubmed: 30227459
Medicine (Baltimore). 2018 Jun;97(25):e11054
pubmed: 29923996
Ann Surg Oncol. 2013 May;20(5):1444-50
pubmed: 23512077
Am J Emerg Med. 2009 Jun;27(5):626.e3-4
pubmed: 19497475
J Clin Endocrinol Metab. 2014 Jun;99(6):1915-42
pubmed: 24893135
J Clin Endocrinol Metab. 2005 Apr;90(4):2110-6
pubmed: 15644401
Int J Surg Case Rep. 2018;44:139-142
pubmed: 29501019
Arch Pathol Lab Med. 2008 Aug;132(8):1272-84
pubmed: 18684026
Tokai J Exp Clin Med. 2005 Apr;30(1):35-9
pubmed: 15952297
Nihon Geka Gakkai Zasshi. 2012 Jul;113(4):378-83
pubmed: 22928444
J Clin Hypertens (Greenwich). 2009 Feb;11(2):74-80
pubmed: 19222671

Auteurs

Yutaka Endo (Y)

Department of Surgery, Keio University School of Medicine, Tokyo, 1608582, Japan.

Minoru Kitago (M)

Department of Surgery, Keio University School of Medicine, Tokyo, 1608582, Japan. dragonpegasus@keio.jp.

Masahiro Shinoda (M)

Department of Surgery, Keio University School of Medicine, Tokyo, 1608582, Japan.

Hiroshi Yagi (H)

Department of Surgery, Keio University School of Medicine, Tokyo, 1608582, Japan.

Yuta Abe (Y)

Department of Surgery, Keio University School of Medicine, Tokyo, 1608582, Japan.

Shutaro Hori (S)

Department of Surgery, Keio University School of Medicine, Tokyo, 1608582, Japan.

Masanori Odaira (M)

Department of Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan.

Takahiro Yokose (T)

Department of Surgery, Keio University School of Medicine, Tokyo, 1608582, Japan.

Kaori Kameyama (K)

Department of Pathology, Keio University School of Medicine, Tokyo, Japan.

Yuko Kitagawa (Y)

Department of Surgery, Keio University School of Medicine, Tokyo, 1608582, Japan.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH