Endocrine Abstracts

Introduction: Paragangliomas are rare endocrine tumors that represent extra-adrenal localization of pheochromocytomas. Signs of catecholamine excess are the most found manifestation of this tumor especialy hypertension. However, paragangliomas can be asymptomatic or can manifest with nonspecific signs. The association between pheochromocytomas and inflammatory diseases is exceptional.

Observation: Here we report the case of a 26 years old male that was admitted into the internal medicine unit for exploration of arterial hypertension associated with a flush syndrome. The clinical manifestation started five months before his admission. He presented a weight loss with abdominal pain and diarrhea. On the physical exam, the patient had a diffuse sensibility. The diagnosis of pheochromocytoma was highly suspected. Blood investigations revealed an elevation of metanephrines 200 times the normal level but the abdominal scan showed a bilateral retroperitoneal mass. An MIBG scintigraphy demonstrated an intense fixation in the latero-aortic region and the inter aortocaval space. The patient was operated successfully and the diagnosis of paraganglioma was confirmed histologically. However, we noted the persistence of diarrhea so a colonoscopy with biopsy was performed and the diagnosis of ulcerative colitis (UC) was posed.

Conclusion: This is the first case to demonstrate the possible association between ulcerative colitis and paraganglioma. Even though paraganglioma can manifest with diarrhea, inflammatory bowel diseases should be suspected in the absence of amelioration after surgical treatment.