Pheochromocytoma in an elderly patient (case report)

L.Yu. Khamnueva, L.S. Andreeva, M.A. Gryaznova, E.A. Danilova, A.G. Basayeva

1) Irkutsk State Medical University, Department of Endocrinology and Clinical Pharmacology, Irkutsk, Russia; 2) Irkutsk Order of the Badge of Honor Regional Clinical Hospital, Irkutsk, Russia

Background: Timely diagnosis of pheochromocytoma (PCC) is difficult due to the rare occurrence of this pathology (1:200,000 population) and variability of clinical symptoms. One of the manifestations of PCC is arterial hypertension (AH), which can be either paroxysmal in nature or manifest as persistent AH resistant to antihypertensive therapy.
Description of the clinical case: The article considers the clinical case of an elderly patient who, despite typical complaints for FCC and therapy-resistant hypertension, was followed-up for a long time with a diagnosis of arterial hypertension (AH). This led to uncontrolled hypertension and the development of acute cerebrovascular accident (ACVA). For the first time, the diagnosis of FCC was suspected during the treatment of COVID-19 after chest multispiral computed tomography (chest MSCT) and the detection of a formation in the left adrenal gland. Surgical removal of FCC led to normalization of blood pressure (BP) in the postoperative period without taking any antihypertensive drugs.
Conclusion: The presented clinical case shows the importance of the earliest possible diagnosis of FCC in patients with therapy-resistant hypertension in order to avoid the development of serious complications, including ACVA. The article summarizes the current recommendations for the diagnosis of pheochromocytoma, which suggest the determination of blood or urine methylated catecholamine levels (metanephrine, normetanephrine) as specific markers of this disease as first-line diagnostic tests.

Keywords

About the Authors

L. Yu. Khamnueva, Irkutsk State Medical University, Department of Endocrinology and Clinical Pharmacology, Irkutsk, Russia; ORCID: https://orcid.org/0000-0001-6296-898X, eLibrary SPIN: 4933-3080
L.S. Andreeva, Irkutsk State Medical University, Department of Endocrinology and Clinical Pharmacology, Irkutsk, Russia; ORCID: https://orcid.org/0000-0003-4687-0004, eLibrary SPIN: 2221-7452
Maria A. Gryaznova, Cand. Sci. (Med.), Teaching Assistant, Department of Endocrinology and Clinical Pharmacology, Irkutsk State Medical University, Irkutsk, Russia; gryaznova_81@inbox.ru, ORCID: https://orcid.org/0009-0007-6631-6138, eLibrary SPIN: 9760-9435(corresponding author)
E. A. Danilova, Irkutsk Order of the Badge of Honor Regional Clinical Hospital, Irkutsk, Russia
A. G. Basayeva, Irkutsk State Medical University, Department of Endocrinology and Clinical Pharmacology, Irkutsk, Russia

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