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以急性冠状动脉综合征为表现的恶性嗜铬细胞瘤：1例罕见病例报告

Malignant Pheochromocytoma Presenting as Acute Coronary Syndrome: A Report of a Rare Case.

作者信息

Srouji Saif M, Reyes Nicholas, Nadeem Rukhsar, Reyes Nathanael A, Sidhu Sukhampal S, Hakimipour Mehdi

机构信息

Internal Medicine, Saint Agnes Medical Center, Fresno, USA.

Endocrinology, Saint Agnes Medical Center, Fresno, USA.

出版信息

Cureus. 2025 May 4;17(5):e83473. doi: 10.7759/cureus.83473. eCollection 2025 May.

DOI:10.7759/cureus.83473
PMID:40470434
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12133615/
Abstract

Pheochromocytomas are rare tumors of the adrenal medulla. The classic presentation for this condition consists of a triad of symptoms: headache, tachycardia, and sweating in an episodic fashion. Rarely, pheochromocytomas are associated with cardiac pathology specifically acute coronary syndrome (ACS) and cardiomyopathy, which is usually attributed to catecholamine excess. They might also present secondary to elevations in blood pressure or arrhythmias. ECG changes are most often encountered as sinus tachycardia. We present a case of previously undiagnosed pheochromocytoma that showed up as ACS across multiple admissions in the setting of significant obstructive coronary artery disease. We aim to contribute to the growing literature reporting this uncommon presentation in order to showcase these cases to the medical audience.

摘要

嗜铬细胞瘤是肾上腺髓质的罕见肿瘤。这种疾病的典型表现包括一组三联征症状：阵发性头痛、心动过速和出汗。嗜铬细胞瘤很少与心脏病理状况相关，特别是急性冠状动脉综合征（ACS）和心肌病，这通常归因于儿茶酚胺过量。它们也可能继发于血压升高或心律失常。心电图改变最常表现为窦性心动过速。我们报告一例先前未诊断出的嗜铬细胞瘤病例，该病例在严重阻塞性冠状动脉疾病的情况下多次入院时表现为ACS。我们旨在为报道这种罕见表现的不断增加的文献做出贡献，以便向医学受众展示这些病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/f4eb9aa2c89f/cureus-0017-00000083473-i12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/dfe640d61003/cureus-0017-00000083473-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/4038090c0f9d/cureus-0017-00000083473-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/5f8dc4a86165/cureus-0017-00000083473-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/cb63c0e7286d/cureus-0017-00000083473-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/3d84563fca30/cureus-0017-00000083473-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/f01489255acf/cureus-0017-00000083473-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/9d23ccb8a2ea/cureus-0017-00000083473-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/c08df844d336/cureus-0017-00000083473-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/f1527ffcddcd/cureus-0017-00000083473-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/919d67e94749/cureus-0017-00000083473-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/17c575bf3c12/cureus-0017-00000083473-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/f4eb9aa2c89f/cureus-0017-00000083473-i12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/dfe640d61003/cureus-0017-00000083473-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/4038090c0f9d/cureus-0017-00000083473-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/5f8dc4a86165/cureus-0017-00000083473-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/cb63c0e7286d/cureus-0017-00000083473-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/3d84563fca30/cureus-0017-00000083473-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/f01489255acf/cureus-0017-00000083473-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/9d23ccb8a2ea/cureus-0017-00000083473-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/c08df844d336/cureus-0017-00000083473-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/f1527ffcddcd/cureus-0017-00000083473-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/919d67e94749/cureus-0017-00000083473-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/17c575bf3c12/cureus-0017-00000083473-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fd/12133615/f4eb9aa2c89f/cureus-0017-00000083473-i12.jpg

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本文引用的文献

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Pheochromocytoma and Thyroid Storm Presenting as ST-Elevation Myocardial Infarction in a Patient with Non-Obstructive Coronary Arteries.嗜铬细胞瘤和甲状腺危象表现为非阻塞性冠状动脉患者的ST段抬高型心肌梗死。
Eur J Case Rep Intern Med. 2024 Sep 4;11(10):04825. doi: 10.12890/2024_04825. eCollection 2024.
2
Unusual case report of malignant pheochromocytoma presenting with STEMI.恶性嗜铬细胞瘤伴ST段抬高型心肌梗死的罕见病例报告
Eur Heart J Case Rep. 2023 Jul 3;7(7):ytad249. doi: 10.1093/ehjcr/ytad249. eCollection 2023 Jul.
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A complicated case of myocardial infarction with nonobstructive coronary arteries with an underlying pheochromocytoma: a case report.
一例合并潜在嗜铬细胞瘤的非阻塞性冠状动脉心肌梗死复杂病例：病例报告
Clin Hypertens. 2022 Feb 1;28(1):4. doi: 10.1186/s40885-021-00189-9.
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Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas.嗜铬细胞瘤和副神经节瘤的心血管表现及并发症
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Pheochromocytoma presenting as an acute coronary syndrome complicated by acute heart failure: The challenge of a great mimic.表现为急性冠状动脉综合征并伴有急性心力衰竭的嗜铬细胞瘤：一种极具迷惑性疾病的挑战
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Phaeochromocytoma presenting with ST segment elevation myocardial infarction.以ST段抬高型心肌梗死为表现的嗜铬细胞瘤
BMJ Case Rep. 2016 Feb 8;2016:bcr2015214134. doi: 10.1136/bcr-2015-214134.
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Anesthetic considerations on adrenal gland surgery.肾上腺手术的麻醉注意事项
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Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline.嗜铬细胞瘤和副神经节瘤：内分泌学会临床实践指南
J Clin Endocrinol Metab. 2014 Jun;99(6):1915-42. doi: 10.1210/jc.2014-1498.
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Pheochromocytoma: a cause of ST-segment elevation myocardial infarction, transient left ventricular dysfunction, and takotsubo cardiomyopathy.嗜铬细胞瘤：ST 段抬高型心肌梗死、短暂性左心室功能障碍和心尖球形综合征的病因。
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