DiMaria Christina N, Rasquin Lorena I, Hung Pinto Wikien A
Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA, 19141, USA.
Case Rep Endocrinol. 2019 Jul 7;2019:5707968. doi: 10.1155/2019/5707968. eCollection 2019.
Pheochromocytomas are rare catecholamine producing neuroendocrine tumors. The incidence of these tumors is estimated to affect 0.8 per 100,000 person-years and is most common in the fourth to fifth decade of life with equal prevalence in men and women. We describe a case of an 84-year-old male who presented with cycling episodes of severe hypertension and hypotension after an elective cardiac catheterization. Workup of the labile blood pressure revealed a large suprarenal mass and free serum metanephrines (MN) 104 nmol/L (reference range 0.0-0.49 nmol/L) and normetanephrines (NMN) of 24 nmol/L (reference range 0.0-0.89 nmol/L), confirming the diagnosis of a pheochromocytoma. The patient's labile blood pressure was a challenge to manage medically and improved only after aggressive hydration and an alpha-adrenergic antagonist. Of note, this is the second eldest patient known to be published to date with a pheochromocytoma.
嗜铬细胞瘤是一种罕见的分泌儿茶酚胺的神经内分泌肿瘤。据估计，这些肿瘤的发病率为每10万人年0.8例，在40至50岁最为常见，男女患病率相等。我们描述了一例84岁男性患者，在择期心脏导管插入术后出现严重高血压和低血压的周期性发作。对不稳定血压的检查发现一个大的肾上腺肿块，游离血清甲氧基肾上腺素（MN）为104 nmol/L（参考范围0.0 - 0.49 nmol/L），去甲氧基肾上腺素（NMN）为24 nmol/L（参考范围0.0 - 0.89 nmol/L），确诊为嗜铬细胞瘤。患者不稳定的血压在医学管理上是一个挑战，仅在积极补液和使用α - 肾上腺素能拮抗剂后才有所改善。值得注意的是，这是迄今为止已知发表的第二高龄的嗜铬细胞瘤患者。
