Choque-Chávez Fernando, Páez-Carpio Alfredo, Mora Mireia, Montserrat Silvia, Pascagaza Alejandro, Burrel Marta
Department of Radiology, CDI, Hospital Clinic Barcelona, Barcelona, Spain.
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Radiol Case Rep. 2024 Nov 22;20(2):924-928. doi: 10.1016/j.radcr.2024.10.107. eCollection 2025 Feb.
We present the case of a 22-year-old male with a left adrenal pheochromocytoma, initially diagnosed during a workup for thoracic pain. The patient's tumor was refractory to medical management, and surgical resection was ruled out due to high cardiovascular risk, stemming from cyanotic congenital heart disease, aortic aneurysm, and factor VII deficiency. The patient underwent adrenal artery embolization (AAE) as a salvage treatment. Following the procedure, there was an initial reduction in hypertensive crises and biochemical markers, with plasma normetanephrine levels decreasing from 1490 pg/mL to 313 pg/mL. However, over subsequent months, the patient experienced symptom recurrence, and biochemical relapse occurred, with normetanephrine levels rising to 742 pg/mL by 3 months postprocedure. This case highlights the potential for AAE to provide short-term symptom relief and biochemical response; nevertheless, it may not be an effective long-term curative option. More collaborative and prospective studies are needed to assess its success and efficacy.
我们报告一例22岁男性左肾上腺嗜铬细胞瘤病例，最初在因胸痛进行检查时被诊断出来。患者的肿瘤对药物治疗无效，由于存在紫绀型先天性心脏病、主动脉瘤和凝血因子VII缺乏导致的高心血管风险，手术切除被排除。患者接受了肾上腺动脉栓塞术（AAE）作为挽救治疗。术后，高血压危象和生化指标最初有所下降，血浆去甲肾上腺素水平从1490 pg/mL降至313 pg/mL。然而，在随后的几个月里，患者症状复发，生化指标复发，术后3个月时去甲肾上腺素水平升至742 pg/mL。该病例凸显了AAE提供短期症状缓解和生化反应的潜力；然而，它可能不是一种有效的长期治愈选择。需要更多的合作性前瞻性研究来评估其成功率和疗效。
