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Chinese Journal of Clinical Laboratory Management(Electronic Edition) ›› 2024, Vol. 12 ›› Issue (03): 170-174. doi: 10.3877/cma.j.issn.2095-5820.2024.03.008

• Case Report • Previous Articles     Next Articles

A case of pheochromocytoma with abdominal pain as the initial manifestation

Jing Su1,()   

  1. 1. The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou Guangdong 510378, China
  • Received:2023-12-08 Online:2024-08-28 Published:2024-10-14
  • Contact: Jing Su

Abstract:

Objective

To share the diagnosis and treatment experience of a patient with pheochromocytoma (PCC) who presented with abdominal pain as the first symptom, aiming to reduce missed diagnosis and misdiagnosis in clinical frontline diagnosis.

Methods

Six sex hormones and eight hypertension were detected using chemiluminescence technology, the catecholamine hormone were detected using the mass spectrometry. Echocardiography, carotid ultrasound, pituitary magnetic resonance (MR) imaging, and abdominal contrast-enhanced computed tomography (CT) were performed. Additionally, pathological and immunohistochemical techniques were utilized to examine tissue specimens.

Results

Six sex hormones: Promoting lutein was 11.87 IU/L, with other items being normal; eight high blood pressure items are normal; the catecholamine hormone test: 3-methoxy-based was 0.42 nmol/L, and the methamphetamine adrenaline was 3.55 nmol/L, methamphetamine with methamphetamine adrenaline was >20.56 nmol/L; cardiac ultrasound: Mild tricuspid regurgitation was present; cervical vascular color ultrasound: increased blood flow velocity in the left internal carotid artery and left external carotid artery, increased blood flow resistance index in the right vertebral artery, and increased blood flow velocity in the intracranial basilar artery; the pituitary MR examination suggested slight pituitary enlargement, without excluding the possibility of a pituitary microadenoma; abdominal contrast-enhanced CT suggested a right adrenal tumor; histopathological examination confirmed the diagnosis of PCC; immunohistochemistry: Succinate dehydrogenase complex iron sulfur subunit B(SDHB) showed diffuse strong positivity.

Conclusion

After laparoscopic resection of adrenal pheochromocytoma, the patient's catecholamine results returned to normal range, blood pressure returned to normal, and there were no symptoms such as abdominal pain, dizziness, headache, palpitations, and excessive sweating.

Key words: abdominal pain, catecholamine hormone, nuclear magnetic resonance, pheochromocytoma

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