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嗜铬细胞瘤的非典型表现:一名年轻女性室性心动过速的病例报告

Atypical Presentation of Pheochromocytoma: A Case Report of Ventricular Tachycardia in a Young Woman.

作者信息

Singh Gurjot, Goswami Kanishka, Sandhu Kanwarpreet S, Singh Anupam, Trehan Shubam, Singh Didar

机构信息

Internal Medicine, Springfield Memorial Hospital, Springfield, USA.

Hospital Medicine, Springfield Clinic, Springfield, USA.

出版信息

Cureus. 2024 Sep 28;16(9):e70405. doi: 10.7759/cureus.70405. eCollection 2024 Sep.

Abstract

Venturing beyond typical arrhythmias, a case of ventricular tachycardia (VT) in a 28-year-old woman who was initially presenting as benign tachycardia took an unexpected turn as her palpitations evolved to include severe sweating and significant weight loss. Initially, her symptoms like palpitations were treated with metoprolol, and given her age and lack of significant risk factors, the tachycardia was considered benign. However, as time passed, she developed severe sweating and noticeable weight loss, prompting a deeper investigation. This thorough exploration uncovered a 4 cm adrenal mass, which turned out to be pheochromocytoma, a rare tumor that can present with atypical symptoms. Initial diagnoses considered a range of conditions, from idiopathic VT and structural heart disease to electrolyte imbalances and thyroid disorders. Each possibility was carefully evaluated and ruled out, leading to the discovery of elevated plasma free metanephrines and imaging findings that confirmed pheochromocytoma. The successful diagnosis of this case demonstrates the importance of keeping rare conditions like pheochromocytoma in mind, even when initial symptoms suggest a different diagnosis. It serves as a reminder of the value of a comprehensive diagnostic approach and the need to stay vigilant for less common causes behind seemingly straightforward symptoms.

摘要

除了典型的心律失常外,一名28岁女性最初表现为良性心动过速的室性心动过速(VT)病例出现了意想不到的转变,她的心悸症状逐渐发展为严重出汗和显著体重减轻。最初,她的心悸等症状用美托洛尔治疗,鉴于她的年龄和缺乏显著风险因素,这种心动过速被认为是良性的。然而,随着时间的推移,她出现了严重出汗和明显体重减轻,促使进行更深入的调查。这次全面检查发现了一个4厘米的肾上腺肿块,结果是嗜铬细胞瘤,一种可表现出非典型症状的罕见肿瘤。最初的诊断考虑了一系列病症,从特发性室性心动过速、结构性心脏病到电解质失衡和甲状腺疾病。对每种可能性都进行了仔细评估并排除,最终发现血浆游离甲氧基肾上腺素升高以及影像学检查结果证实为嗜铬细胞瘤。该病例的成功诊断表明,即使初始症状提示不同诊断,也应考虑到嗜铬细胞瘤等罕见病症。它提醒人们全面诊断方法的价值以及对看似简单症状背后不太常见病因保持警惕的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3483/11521393/c617800dd494/cureus-0016-00000070405-i01.jpg

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