Kota Sk, Kota Sk, Meher Lk, Jammula S, Mohapatra S, Modi Kd
Department of Anesthesia, Central Security Hospital, Riyadh, Saudi Arabia.
Ann Med Health Sci Res. 2013 Apr;3(2):258-61. doi: 10.4103/2141-9248.113672.
Pheochromocytomas have been described in association with rare vascular abnormalities, most common of them being renal artery stenosis. A 45-year-old woman was admitted to our hospital with complaints of headache, sweating, anxiety, dizziness, nausea, vomiting and severe hypertension. For the last several days, she was having a dull aching abdominal pain with a palpable, pulsatile, expansile and non-tender mass in the epigastric region. Hypertension was confirmed biochemically to result from excess catecholamine production. Abdominal computed tomography revealed the presence of a right adrenal pheochromocytoma. Magnetic resonance imaging of the abdomen demonstrated an abdominal aortic aneurysm (AAA) of maximum transverse diameter of 4.5 cm with 3 cm lumen. Surgical removal of pheochromocytoma resulted in normalization of blood pressure to normal. Because of the asymptomatic 4.5 cm aneurysm, our patient was advised for periodic follow-up. To our belief, this is the first such case report emanating from India, citing this rare association between pheochromocytoma and AAA. It is concluded that when the two diseases occur simultaneously, both must be diagnosed accurately and treated adequately. Possible mechanisms of such an uncommon association are also discussed.
嗜铬细胞瘤已被描述与罕见的血管异常相关，其中最常见的是肾动脉狭窄。一名45岁女性因头痛、出汗、焦虑、头晕、恶心、呕吐和严重高血压入院。在过去几天里，她一直有上腹部隐痛，上腹部可触及一个搏动性、扩张性且无压痛的肿块。经生化检查证实高血压是由儿茶酚胺分泌过多引起的。腹部计算机断层扫描显示右侧肾上腺嗜铬细胞瘤。腹部磁共振成像显示腹主动脉瘤（AAA），最大横径4.5厘米，管腔直径3厘米。手术切除嗜铬细胞瘤后血压恢复正常。由于4.5厘米的动脉瘤无症状，建议患者定期随访。据我们所知，这是印度首例此类病例报告，提及嗜铬细胞瘤与腹主动脉瘤之间的这种罕见关联。结论是，当这两种疾病同时发生时，必须准确诊断并进行充分治疗。还讨论了这种罕见关联的可能机制。
