Davis Matthew A, Bove Geoffrey M
Carlos G Otis Health Care Center Inc, PO Box 216, Townshend, VT 05353, USA.
J Manipulative Physiol Ther. 2007 Oct;30(8):598-601. doi: 10.1016/j.jmpt.2007.06.009.
This case report describes and discusses a patient with a pheochromocytoma who presented to a chiropractic office with low back pain.
The patient is a 51-year-old woman who was self-referred to our chiropractic service with low back pain that appeared to be musculoskeletal in nature. Four days after chiropractic consultation, she collapsed in cardiogenic shock with signs of congestive heart failure, left ventricular dysfunction, and hypotension. Computed tomographic image of the abdomen revealed a right-sided adrenal mass that was confirmed via laboratory analysis to be a pheochromocytoma.
The patient underwent laparoscopic adrenalectomy and made a full recovery. Her initial back symptoms resolved with tumor excision.
Pheochromocytomas are rare catecholamine-producing tumors of the adrenal glands that can mimic musculoskeletal conditions such as low back pain. Chiropractic physicians should be aware of the various clinical presentations and, when pheochromocytoma is suspected, make prompt referral to medical providers for diagnostic evaluation and treatment.
本病例报告描述并讨论了一名患有嗜铬细胞瘤的患者,该患者因腰痛就诊于一家整脊诊所。
患者为一名51岁女性,因看似肌肉骨骼性质的腰痛自行前来我们的整脊服务机构就诊。整脊咨询4天后,她因心源性休克而晕倒,伴有充血性心力衰竭、左心室功能障碍和低血压的症状。腹部计算机断层扫描图像显示右侧肾上腺有一个肿块,经实验室分析证实为嗜铬细胞瘤。
患者接受了腹腔镜肾上腺切除术并完全康复。她最初的背部症状随着肿瘤切除而缓解。
嗜铬细胞瘤是肾上腺罕见的分泌儿茶酚胺的肿瘤,可以模拟如腰痛等肌肉骨骼疾病。整脊医生应了解各种临床表现,当怀疑患有嗜铬细胞瘤时,应及时转诊给医疗服务提供者进行诊断评估和治疗。