ECE2022 Eposter Presentations Adrenal and Cardiovascular Endocrinology (131 abstracts)
Pheochromocytoma in the elderly: treatment challenges
Imen Halloul , Ach Taieb , Saad Ghada , Ben Abdelkerim Asma , El Fekih Hamza , Hasni Yosra , Maaroufi Amel , Kacem Maha , Chaieb Molka & Ach Koussay
Farhat Hached University Hospital, Department of Endocrinology and Diabetes, Sousse, Tunisia.
Introduction: Pheochromocytoma is a rare neuroendocrine tumor with a prevalence ranging from 0.05% to 0.1%. Those tumors are usually diagnosed in young adults. However, they can also affect children and the elderly, with sporadic cases being more common in older patients. Giving the recent increases in life expectancy and improvements in imaging techniques, there has been an increase in the number of pheochromocytoma in the elderly.
Case presentation: An 85-year-old female patient was admitted to our endocrinology department for exploration of adrenal incidentaloma. She was followed for hypothyroidism and hypertension for 10 years now. The mass was discovered at an abdominal CT scan when the patient developed vomiting and abdominal pain. The mass was a heterogeneous 65 mm tumor of the left adrenal gland, with a spontaneous density of 55 UH and was in contact to the left renal vein. Biological explorations confirmed the presence of a pheochromocytoma with an elevated level of metanephrines and normetanephrines (5* the normal range). Treatment with doxazosin was administered for 2 weeks in preparation for surgery. A left adrenalectomy was performed without incidents. Histologically, the tumor was confirmed to be a benign pheochromocytoma. The follow-up showed a complete remission with a normal blood pressure and a normal level of plasmatic metanephrine.
Conclusion: Management of pheochromocytoma is delicate in the elderly population, giving the comorbidities associated. Thus, surgical removal should be made by an experienced multidisciplinary team to avoid post-operative complications. Meticulous preparation for surgery is crucial with a particular attention on maintaining balance between the adrenal disease and comorbidities.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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