Department of Intensive Care Unit, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Department of Mathematics and Statistics, University of San Francisco, CA, USA.
J Int Med Res. 2024 Sep;52(9):3000605241270655. doi: 10.1177/03000605241270655.
Pheochromocytoma crisis is rare but potentially fatal if not recognized early and properly managed. Here, a woman in her 20s with a paraganglioma-induced pheochromocytoma crisis, who was successfully treated by veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and interval tumor resection, is described. In July 2022, the patient was brought to hospital with a complaint of sudden-onset of palpitations with vomiting. The patient developed cardiorespiratory failure with hypoxia. Computed tomography scan showed pulmonary oedema and a mass anterior to the inferior vena cava. She was transferred to the intensive care unit and treated with VA-ECMO. The patient's ECMO was withdrawn after 6 days without any complications. After hemodynamic stabilization, the patient underwent tumor resection 4 months later. The postoperative course was uneventful and she was discharged on postoperative day 7. Histopathological analysis confirmed a paraganglioma. VA-ECMO may play a significant role in saving lives and providing time for accurate diagnosis and specific treatment of a patient with pheochromocytoma crisis. Appropriate individual management can help avoid the occurrence of ECMO complications.
嗜铬细胞瘤危象罕见，但如果早期未被识别和正确处理，可能会致命。本文介绍了一位 20 多岁的女性患者，因副神经节瘤引起的嗜铬细胞瘤危象，通过静脉-动脉体外膜肺氧合（VA-ECMO）和间隔肿瘤切除术成功治疗。2022 年 7 月，患者因突发心悸伴呕吐被送往医院。患者出现呼吸循环衰竭伴缺氧。计算机断层扫描显示肺水肿和下腔静脉前肿块。她被转至重症监护病房并接受 VA-ECMO 治疗。患者的 ECMO 在没有任何并发症的情况下在 6 天后撤出。血流动力学稳定后，患者在 4 个月后进行了肿瘤切除术。术后过程顺利，患者在术后第 7 天出院。组织病理学分析证实为副神经节瘤。VA-ECMO 在挽救生命和为嗜铬细胞瘤危象患者提供准确诊断和特定治疗的时间方面可能发挥重要作用。适当的个体化管理有助于避免 ECMO 并发症的发生。
