Saxena Mehul, Roy Shubhajeet, Gaurav Kushagra, Anand Akshay, Rana Chanchal, Sonkar Abhinav Arun
Faculty of Medical Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India.
Department of Surgery (General), King George's Medical University, Lucknow, Uttar Pradesh, India.
J Minim Access Surg. 2025 Apr 1;21(2):209-213. doi: 10.4103/jmas.jmas_329_23. Epub 2024 Aug 12.
Hydatid cysts, caused by Echinococcus larval infections, are common in certain regions. In an unusual medical case, a 26-year-old female with a hydatid cyst was unexpectedly found to have an adrenal pheochromocytoma, a rare tumour producing catecholamines. She initially complained of persistent, non-specific right upper abdominal pain. Imaging revealed a cystic lesion resembling a hydatid cyst. During surgery, unexpected arrhythmia and electrocardiographic changes led to the suspicion of acute coronary syndrome, halting the procedure. Further investigation revealed elevated urinary metanephrine levels and a suspicious soft-tissue mass, resulting in laparoscopic right adrenalectomy with hypertensive spikes. The patient was successfully managed, and post-operative examination confirmed the adrenal pheochromocytoma. Hydatid cysts usually present with non-specific symptoms and are diagnosed through imaging. Similarly, diagnosing cystic pheochromocytomas is challenging without typical symptoms, potentially leading to intraoperative complications. Misdiagnosed cases can result in hypertensive crises and hypotension, requiring specific management. Due to their variable presentation and rarity, pheochromocytomas are often misdiagnosed.
由棘球绦虫幼虫感染引起的包虫囊肿在某些地区很常见。在一个不寻常的医疗案例中，一名患有包虫囊肿的26岁女性意外被发现患有肾上腺嗜铬细胞瘤，这是一种罕见的产生儿茶酚胺的肿瘤。她最初抱怨右上腹持续出现非特异性疼痛。影像学检查发现一个类似包虫囊肿的囊性病变。手术过程中，意外的心律失常和心电图变化引发了对急性冠状动脉综合征的怀疑，导致手术中断。进一步检查发现尿间甲肾上腺素水平升高以及一个可疑的软组织肿块，最终通过腹腔镜进行了右肾上腺切除术，并伴有高血压发作。患者得到了成功治疗，术后检查确诊为肾上腺嗜铬细胞瘤。包虫囊肿通常表现为非特异性症状，通过影像学检查进行诊断。同样，在没有典型症状的情况下，诊断囊性嗜铬细胞瘤具有挑战性，可能导致术中并发症。误诊病例可能导致高血压危象和低血压，需要特殊处理。由于其表现多样且罕见，嗜铬细胞瘤常常被误诊。
