ECE2018 Poster Presentations: Adrenal and Neuroendocrine Tumours Clinical case reports - Pituitary/Adrenal (21 abstracts)
Intracerebral hemorrhage as a first sign of pheochromocytoma
Sandra Pekic Djurdjevic 1, , Vladimir Jovanovic 2, , Goran Tasic 2, , Ivan Paunovic 2, , Svetislav Tatic 2, , Dusko Dundjerovic 2, , Mirjana Doknic 1, , Dragana Miljic 1, , Marko Stojanovic 1, , Zvezdana Jemuovic 1 , Marina Nikolic Djurovic 1, , Vera Popovic 2 & Milan Petakov 1,
1Clinic for Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center, Belgrade, Serbia; 2School of Medicine, University of Belgrade, Belgrade, Serbia; 3Clinic for Neurosurgery, University Clinical Center, Belgrade, Serbia; 4Clinic for Endocrine Surgery, Belgrade, Serbia. 5Clinic for Pathology, Medical Faculty, Belgrade, Serbia.
Pheochromocytomas and sympathetic paragangliomas are rare catecholamine-secreting tumors and represent very rare causes of intracerebral hemorrhage in young. Few cases of these neuroendocrine tumors which presented with intracerebral hemorrhage have been reported. A 32-year-old man presented to our emergency department because of sudden onset of severe headache. He has a six months history of headache, palpitations and sweating. During examination he became somnolent and developed hemiplegia of the left side of the body. A computed tomographic scan of the brain showed a right temporoparietal hematoma. He was admitted to the Clinic for Neurosurgery and hematoma was evacuated. The patient was comatous, on assisted respiration and developed hypertensive crises. An examination for possible secondary causes of hypertension was undertaken. Plasma metanephrine value was elevated (414 pg/ml, reference values <90 pg/ml). Abdominal computed tomographic scans revealed a large mass (6 cm) in the right adrenal gland. After adequate control of the hypertension was achieved with an nonselective α and β adrenergic blockers, the tumor was excised. The histopathologic findings confirmed the diagnosis of pheochromocytoma. The genetic analysis demonstrated a duplication in exon 1 of VHL gene. We reported a rare, potentially fatal complication of pheochromocytoma, an intracerebral hemorrhage. This case and review of the similar rare cases in the literature illustrate the importance of early recognition of the characteristic symptoms of catecholamine excess in a young patient with hypertension.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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