Endocrine Abstracts

Introduction: Pheochromocytoma is a rare neuroendocrine tumor. It is usually diagnosed in subjects between 40 and 50 years of age. The occurrence of pheochromocytoma in the elderly is much rarer and has its own particularities. We report the case of a 70-year-old female patient with invasive pheochromocytoma.

Case presentation: A 70-year-old female patient with a history type 2 diabetes for 18 years on oral antidiabetics and insulin. The history of his disease goes back to a few months with an important weight loss, and the installation of a menard triad made of headaches, sweats and palpitations. Exploration showed a suspicious adrenal mass on abdominal CT. Urinary methoxylate assays showed very high levels of metanephrines and normetanephrines. The patient underwent a laparoscopic right adrenalectomy. Pathological examination was in favor of an invasive pheochromocytoma. During the follow-up, the methoxylated derivatives assay was negative.

Discussion: Pheochromocytoma is a benign tumor that develops at the expense of chromaffin cells and secretes catecholamines. Clinical signs are dominated by permanent or paroxysmal hypertension. It rarely occurs in elderly subjects and symptoms may be more subtle and less specific in this age group. In our patient, pheochromocytoma was revealed by weight loss and Menard’s triad. It is also more common in the elderly to develop multiple or malignant pheochromocytomas. In our patient the anatomopathological examination showed an invasive pheochromocytoma. A meticulous clinical examination and a regular medical follow-up are essential for the detection of pheochromocytoma in the elderly subject.