Malignant pheochromocytoma masquerading as acute pancreatitis--a rare but potentially lethal occurrence.

Pheochromocytoma mimicking acute pancreatitis as its initial clinical manifestation is a known, albeit rare, phenomenon. Herein we describe a patient with this occurrence. A striking feature was pronounced hyperamylasemia, almost exclusively of the S-type. Our theory is that the pheochromocytoma caused a catecholamine-induced cardiomyopathy, which contributed to failure of the left ventricle; pulmonary edema and release of S-type amylase from hypoxic lung tissue occurred subsequently.