Extra-adrenal pheochromocytoma 12 years in the making.

摘要

A 32-year-old man was evaluated for uncontrolled hypertension in April 2004. He had a family history of essential hypertension including his father and two cousins, but there was no family history of endocrine tumours or sudden death. He had been treated since the age of 20 with calcium channel blockers and angiotensin-converting enzyme inhibitors with satisfactory results. Four months before admission, his blood pressure became increasingly difficult to control and he began to have palpitations and bouts of sweating but denied any headaches. A 24-h urine metanephrine level was 10.6 mmol/mmol creatinine (normal up to 0.7). A computed tomography scan of the abdomen and pelvis showed normal kidneys and adrenals, but a 7 cm by 5 cm retroperitoneal soft tissue mass was found anterior to the right kidney. The inferior vena cava was draped along the periphery of the mass (Fig. 1). The mass was resected by open laparotomy and was found to be invading the wall of the inferior vena cava (Fig. 2). Post-operatively, his blood pressure remained near 120/70 without medications, and his palpitations and sweating resolved.