Smircić L, Susković T, Ferencić Z
Department of Internal Medicine, Clinical Hospital Sestre Milosrdnice, Zagreb, Croatia.
J Intern Med. 1994 Apr;235(4):373-4. doi: 10.1111/j.1365-2796.1994.tb01089.x.
Pheochromocytoma is a rare tumour which is usually suggested by sustained or paroxysmal hypertension. Our patient with a pheochromocytoma was unusual for two reasons: she was normotensive during 3 weeks of close observation in the hospital and the urinary adrenaline level was higher than the noradrenaline level. In the patient's history there were no data on hypertension attacks. The patient had a palpable abdominal mass and the cytological finding was in contrast with a clinical diagnosis of pheochromocytoma. The surgery revealed a tumour and the pathohistologic evaluation established the diagnosis of pheochromocytoma. After surgery, the patient's urinary catecholamine levels reverted to normal. Our patient may have been normotensive because her tumour predominantly secreted adrenaline and perhaps other vasodilating substances.
嗜铬细胞瘤是一种罕见肿瘤,通常由持续性或阵发性高血压提示。我们这位患有嗜铬细胞瘤的患者有两点不同寻常:她在医院密切观察的3周内血压正常,且尿肾上腺素水平高于去甲肾上腺素水平。患者病史中没有高血压发作的数据。患者可触及腹部肿块,细胞学检查结果与嗜铬细胞瘤的临床诊断不符。手术发现了一个肿瘤,病理组织学评估确诊为嗜铬细胞瘤。术后,患者的尿儿茶酚胺水平恢复正常。我们的患者可能血压正常,因为她的肿瘤主要分泌肾上腺素,或许还分泌其他血管舒张物质。