Bethishou Britiel, Fox-McClary Debora J, Wcislak Susan
Surgery, Arizona College of Osteopathic Medicine, Midwestern University, Glendale, USA.
Colon and Rectal Surgery, Abrazo Community Health Network, Glendale, USA.
Cureus. 2024 Sep 23;16(9):e70053. doi: 10.7759/cureus.70053. eCollection 2024 Sep.
A pheochromocytoma is a rare tumor of neuroendocrine origin that secretes hormones like epinephrine, norepinephrine, and occasionally dopamine. The most notable symptom of the release of catecholamines is exceedingly high blood pressure. A 45-year-old male presented with a symptomatic pheochromocytoma of large size. He reported experiencing fatigue, orthopnea, dizziness, headache, and chest tightness with deep inspiration for several months. At the time of presentation, he was found to be in hypertensive emergency and was started on alpha-blockade for several days followed by a beta-blockade for a total of 28 days of anti-hypertensive treatment. During his admission, CT imaging showed his tumor to measure at least 14 cm in length, larger than most. After stabilization of the patient, an attempt was made to resect the tumor robotically, but the procedure was converted to an open left adrenalectomy owing to the size of the tumor and the number of tributaries. The patient tolerated the procedure well and, afterward, his blood pressure normalized. He recovered postoperatively with minimal hypotensive episodes and was started on physical therapy. This report reviews the details and management of this case.
嗜铬细胞瘤是一种罕见的神经内分泌源性肿瘤，可分泌肾上腺素、去甲肾上腺素，偶尔也分泌多巴胺等激素。儿茶酚胺释放最显著的症状是血压极高。一名45岁男性患有有症状的大尺寸嗜铬细胞瘤。他报告称数月来一直感到疲劳、端坐呼吸、头晕、头痛以及深吸气时胸部发紧。就诊时，发现他处于高血压急症状态，先接受了数天的α受体阻滞剂治疗，随后接受β受体阻滞剂治疗，总共进行了28天的降压治疗。在他住院期间，CT成像显示他的肿瘤长度至少为14厘米，比大多数肿瘤都大。患者病情稳定后，尝试通过机器人手术切除肿瘤，但由于肿瘤大小和分支数量，手术改为开放性左肾上腺切除术。患者对手术耐受良好，术后血压恢复正常。他术后恢复良好，低血压发作极少，并开始接受物理治疗。本报告回顾了该病例的详细情况及治疗过程。
