Kudoh Y, Kuroda S, Shimamoto K, Iimura O
Kidney Unit, South-One Hospital, Sapporo, Japan.
Jpn Circ J. 1995 Jun;59(6):365-71. doi: 10.1253/jcj.59.365.
A 43-year-old female was admitted for a labile hypertension and depression. High levels of plasma and urinary noradrenaline strongly suggested a pheochromocytoma. However, clinical investigations revealed a normal adrenal gland and thoraco-abdominal region. Venous samples from multiple sites indicated and increase in noradrenaline in the left jugular vein. Using computed tomography and Gadolinium DTPA (diethylene triamine pentaacetic acid)-enhanced dynamic MR (magnetic resonance) imaging, a tumor was discovered in the cerebello-pontine angle. Carotid angiography showed the feeder arteries clearly. Therefore, the tumor was classified as a noradrenaline-secreting glomus jugulare tumor fed by the carotid artery. After embolization and subsequent medical therapy, blood pressure was well controlled. Twenty cases of intracranial pheochromocytoma have been reported to date. This is the second such case in Japan.
一名43岁女性因血压波动和抑郁入院。血浆和尿中去甲肾上腺素水平升高强烈提示嗜铬细胞瘤。然而,临床检查显示肾上腺及胸腹部区域正常。多个部位的静脉血样显示左颈静脉去甲肾上腺素水平升高。通过计算机断层扫描和钆喷酸葡胺(二乙三胺五乙酸)增强动态磁共振成像,在桥小脑角发现一个肿瘤。颈动脉血管造影清晰显示了供血动脉。因此,该肿瘤被分类为颈动脉供血的分泌去甲肾上腺素的颈静脉球瘤。栓塞及后续药物治疗后,血压得到良好控制。迄今为止,已报道20例颅内嗜铬细胞瘤。这是日本的第二例此类病例。