Ishikawa Takumi, Takezawa Kentaro, Abe Toyofumi, Fukuhara Shinichiro, Uemura Motohide, Kiuchi Hiroshi, Imamura Ryoichi, Nonomura Norio
The Department of Urology, Osaka University Graduate School of Medicine.
Hinyokika Kiyo. 2021 Nov;67(11):501-505. doi: 10.14989/ActaUrolJap_67_11_501.
A 25-year-old woman, with chief complaints of palpitation and vomiting, was suspected of having acute myocarditis and was taken to our critical care center. She was diagnosed with Takotsubo syndrome based on the results of echocardiography, coronary angiography, and myocardial biopsy. The 24-hour urine test showed high levels of normetanephrine and noradrenaline. The abdominal computed tomographic scan showed a presacral tumor (26 mm) just below the aortic bifurcation, and ¹³¹I-meta-iodobenzylguanidine scintigraphy showed abnormal accumulation in the tumor. Finally, she was diagnosed with Takotsubo syndrome associated with presacral paraganglioma. The hemodynamics became stable with conservative treatment. Then she underwent elective laparoscopic surgery. The histopathological analysis revealed paraganglioma. The immunohistochemistry for succinate dehydrogenase was negative in the tumor cells. There has been no recurrence as of 15 months after surgery.
一名25岁女性，主要症状为心悸和呕吐，怀疑患有急性心肌炎，被送往我们的重症监护中心。根据超声心动图、冠状动脉造影和心肌活检结果，她被诊断为应激性心肌病。24小时尿液检测显示去甲肾上腺素和肾上腺素水平升高。腹部计算机断层扫描显示在主动脉分叉下方有一个骶前肿瘤（26毫米），¹³¹I-间碘苄胍闪烁显像显示肿瘤有异常积聚。最终，她被诊断为与骶前副神经节瘤相关的应激性心肌病。经过保守治疗，血流动力学变得稳定。然后她接受了择期腹腔镜手术。组织病理学分析显示为副神经节瘤。肿瘤细胞中琥珀酸脱氢酶的免疫组织化学检测为阴性。截至术后15个月，未出现复发。
