Phaeochromocytoma Crisis: Two Cases of Undiagnosed Phaeochromocytoma Presenting After Elective Nonrelated Surgical Procedures

Overview

Journal Case Rep Anesthesiol

Publisher Wiley

Specialty Anesthesiology

Date 2013 Nov 30

PMID 24288628

Citations 6

Authors

P C Johnston

J A Silversides

H Wallace

P A Farling

A Hutchinson

S J Hunter

F Eatock

K R Mullan

Affiliations

Soon will be listed here.

Abstract

Phaeochromocytoma is a catecholamine producing tumour and an uncommon cause of hypertension. We present two cases of relatively asymptomatic individuals, in which previously undiagnosed phaeochromocytoma was unmasked by elective nonadrenal surgical procedures, manifesting as postoperative hypertensive crisis and subsequent cardiogenic shock. The initial management in intensive care is discussed, in addition to the clinical and biochemical diagnostic challenges present. Successful adrenalectomy was performed in each case.

Citing Articles

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Intraoperative hemodynamics monitoring in a patient with pheochromocytoma multisystem crisis: a case report.

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Extracorporeal membrane oxygenation for pheochromocytoma-induced cardiogenic shock.

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References

Sojod G, Diana M, Wall J, dAgostino J, Mutter D, Marescaux J . Successful extracorporeal membrane oxygenation treatment for pheochromocytoma-induced acute cardiac failure. Am J Emerg Med. 2011; 30(6):1017.e1-3. DOI: 10.1016/j.ajem.2011.05.006. View

Oshima S, Iida T, Ishihara H, Kudo T, Matsuki A, Oyama T . [Unsuspected pheochromocytoma showing periodic and extreme fluctuation in blood pressure during and after abdominal surgery--a case report]. Masui. 1988; 37(4):470-5. View

Kinney M, Narr B, Warner M . Perioperative management of pheochromocytoma. J Cardiothorac Vasc Anesth. 2002; 16(3):359-69. DOI: 10.1053/jcan.2002.124150. View

Grosse H, Schroder D, Schober O, Hausen B, Dralle H . [The importance of high-dose alpha-receptor blockade for blood volume and hemodynamics in pheochromocytoma]. Anaesthesist. 1990; 39(6):313-8. View

Westaby S, Shahir A, Sadler G, Flynn F, Ormerod O . Mechanical bridge to recovery in pheochromocytoma myocarditis. Nat Rev Cardiol. 2009; 6(7):482-7. DOI: 10.1038/nrcardio.2009.58. View

Wooster D, Mitchell R . Unsuspected phaeochromocytoma presenting during surgery. Can Anaesth Soc J. 1981; 28(5):471-4. DOI: 10.1007/BF03010359. View

Lo C, Lam K, Wat M, Lam K . Adrenal pheochromocytoma remains a frequently overlooked diagnosis. Am J Surg. 2000; 179(3):212-5. DOI: 10.1016/s0002-9610(00)00296-8. View

Banfi C, Juthier F, Ennezat P, de Saint Denis T, Carnaille B, Leteurtre E . Central extracorporeal life support in pheochromocytoma crisis. Ann Thorac Surg. 2012; 93(4):1303-5. DOI: 10.1016/j.athoracsur.2011.09.018. View

Pacak K . Preoperative management of the pheochromocytoma patient. J Clin Endocrinol Metab. 2007; 92(11):4069-79. DOI: 10.1210/jc.2007-1720. View

10.

Walther M, KEISER H, Linehan W . Pheochromocytoma: evaluation, diagnosis, and treatment. World J Urol. 1999; 17(1):35-9. DOI: 10.1007/s003450050102. View

11.

Shen J, Yu R . Perioperative management of pheochromocytoma: the heart of the issue. Minerva Endocrinol. 2013; 38(1):77-93. View

12.

Scholten A, Cisco R, Vriens M, Cohen J, Mitmaker E, Liu C . Pheochromocytoma crisis is not a surgical emergency. J Clin Endocrinol Metab. 2013; 98(2):581-91. DOI: 10.1210/jc.2012-3020. View

13.

Ritter S, Guertler T, Meier C, Genoni M . Cardiogenic shock due to pheochromocytoma rescued by extracorporeal membrane oxygenation. Interact Cardiovasc Thorac Surg. 2011; 13(1):112-3. DOI: 10.1510/icvts.2011.266023. View

14.

Bravo E, Tagle R . Pheochromocytoma: state-of-the-art and future prospects. Endocr Rev. 2003; 24(4):539-53. DOI: 10.1210/er.2002-0013. View

15.

Hariskov S, Schumann R . Intraoperative management of patients with incidental catecholamine producing tumors: A literature review and analysis. J Anaesthesiol Clin Pharmacol. 2013; 29(1):41-6. PMC: 3590540. DOI: 10.4103/0970-9185.105793. View

16.

Marcovitz P, Czako P, Rosenblatt S, Billecke S . Pheochromocytoma presenting with Takotsubo syndrome. J Interv Cardiol. 2010; 23(5):437-42. DOI: 10.1111/j.1540-8183.2010.00551.x. View

17.

Naderi N, Amin A, Setayesh A, Pouraliakbar H, Mozaffari K, Maleki M . Pheochromocytoma-induced reverse tako-tsubo with rapid recovery of left ventricular function. Cardiol J. 2012; 19(5):527-31. DOI: 10.5603/cj.2012.0097. View

18.

Mannelli M, Dralle H, Lenders J . Perioperative management of pheochromocytoma/paraganglioma: is there a state of the art?. Horm Metab Res. 2012; 44(5):373-8. DOI: 10.1055/s-0032-1306275. View

19.

Wood R, Commerford P, Rose A, Tooke A . Reversible catecholamine-induced cardiomyopathy. Am Heart J. 1991; 121(2 Pt 1):610-3. DOI: 10.1016/0002-8703(91)90740-9. View