Kasaliwal Rajeev, Sarathi Vijaya, Pandit Reshma, Budyal Sweta R, Bukan Amol, Kakade Harshal, Jagtap Varsha S, Lila Anurag R, Bandgar Tushar, Menon Padmavathy S, Shah Nalini S
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Endocr Pract. 2014 May;20(5):e80-5. doi: 10.4158/EP13408.CR.
To describe a case of pheochromocytoma (PHEO) with tetralogy of Fallot (TOF) and discuss the difficulties encountered during the management of this patient, with a review of the literature.
We report the clinical course, imaging, and management issues of our patient and review relevant literature.
A 14-year-old female who was known to have TOF presented with classical paroxysmal symptoms and worsening dyspnea. She was diagnosed as having epinephrine-secreting PHEO based on biochemical, radiologic, and functional imaging. She was treated with an α-1 blocker for control of paroxysms but developed severe cyanotic spells. She required addition of a calcium-channel blocker for control of the paroxysms and underwent successful cardiac repair.
Treatment of the combination of cyanotic congenital heart disease (CCHD) and PHEO requires an individualized and multidisciplinary approach with judicious use of available medications. This is the first case of uncorrected TOF and epinephrine-secreting PHEO. Our case also reiterates the need for further studies to better understand the pathophysiologic link between PHEO/paraganglioma and CCHD.
