Bilateral adrenal pheochromocytomas in a 14 year-old boy
Introduction: Pheochromocytomas are catecholamine-secreting tumors arise from chromaffin cells of the adrenal medulla. Classical symptoms include palpitations, headaches, sweating and paroxysmal hypertension as a result of elevated catecolamine production. This case report aims to describe the clini...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-12-01
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| Series: | Journal of Pediatric Surgery Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576619302532 |
| _version_ | 1830453243697692672 |
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| author | Vanessa Lini Gunawan Ketut Suarta Gusti Ayu Putu Nilawati I Made Arimbawa Made Darmajaya Kadek Deddy Ariyanta Pande Putu Yuli Anandasari I Nyoman Budi Hartawan |
| author_facet | Vanessa Lini Gunawan Ketut Suarta Gusti Ayu Putu Nilawati I Made Arimbawa Made Darmajaya Kadek Deddy Ariyanta Pande Putu Yuli Anandasari I Nyoman Budi Hartawan |
| author_sort | Vanessa Lini Gunawan |
| collection | DOAJ |
| description | Introduction: Pheochromocytomas are catecholamine-secreting tumors arise from chromaffin cells of the adrenal medulla. Classical symptoms include palpitations, headaches, sweating and paroxysmal hypertension as a result of elevated catecolamine production. This case report aims to describe the clinical presentation, management and outcome of the phechromocytomas. Case: A 14 year-old boy came with hypertensive crisis (blood pressure 220/140 mmHg), recurrent tension headache, excessive sweating, palpitation and weight loss during the last 1 year. Twenty four hour urinary catecholamine level was normal. Abdominal CT scan confirmed the suspicion of pheochromocytoma. After having preoperative treatment with nicardipine infusion, oral nifedipine and captopril, bilateral cortical sparing adrenalectomy was done. Nicardipine infusion was administered to maintain the blood pressure during surgery. Histopathology confirmed the diagnosis of adrenal pheochromocytoma Adrenocortical was preserved. Complete resolution of hypertension was achieved gradually after one month. Conclusion: Pheochromocytomas is a rare disease which may lead to a life-threatening hypertension as a result of elevated catecolamine production. Initial recognition and appropriate management of pheochromocytomas are important. Preoperative management to normalize blood pressure followed by tumor removal has proved to be the ideal choice for good prognosis. Multidisciplinary team during preoperative, intraoperative and postoperative are required for successful outcome. Keywords: Bilateral adrenal pheochromocytoma, Bilateral cortical sparing adrenalectomy, Hypertensive crisis |
| first_indexed | 2024-12-21T09:03:35Z |
| format | Article |
| id | doaj.art-235dd0d3c9aa425382c408c95fc99828 |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-12-21T09:03:35Z |
| publishDate | 2019-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-235dd0d3c9aa425382c408c95fc998282022-12-21T19:09:24ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662019-12-0151Bilateral adrenal pheochromocytomas in a 14 year-old boyVanessa Lini Gunawan0Ketut Suarta1Gusti Ayu Putu Nilawati2I Made Arimbawa3Made Darmajaya4Kadek Deddy Ariyanta5Pande Putu Yuli Anandasari6I Nyoman Budi Hartawan7Department of Child Health, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, Indonesia; Corresponding author. Department of Child Health, Udayana University, Sanglah Hospital, Denpasar, Bali, Jalan Kesehatan no.1, Denpasar, Bali, Indonesia.Department of Child Health, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, IndonesiaDepartment of Child Health, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, IndonesiaDepartment of Child Health, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, IndonesiaDepartment of Pediatric Surgery, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, IndonesiaDepartment of Pediatric Surgery, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, IndonesiaDepartment of Radiology, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, IndonesiaDepartment of Child Health, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, IndonesiaIntroduction: Pheochromocytomas are catecholamine-secreting tumors arise from chromaffin cells of the adrenal medulla. Classical symptoms include palpitations, headaches, sweating and paroxysmal hypertension as a result of elevated catecolamine production. This case report aims to describe the clinical presentation, management and outcome of the phechromocytomas. Case: A 14 year-old boy came with hypertensive crisis (blood pressure 220/140 mmHg), recurrent tension headache, excessive sweating, palpitation and weight loss during the last 1 year. Twenty four hour urinary catecholamine level was normal. Abdominal CT scan confirmed the suspicion of pheochromocytoma. After having preoperative treatment with nicardipine infusion, oral nifedipine and captopril, bilateral cortical sparing adrenalectomy was done. Nicardipine infusion was administered to maintain the blood pressure during surgery. Histopathology confirmed the diagnosis of adrenal pheochromocytoma Adrenocortical was preserved. Complete resolution of hypertension was achieved gradually after one month. Conclusion: Pheochromocytomas is a rare disease which may lead to a life-threatening hypertension as a result of elevated catecolamine production. Initial recognition and appropriate management of pheochromocytomas are important. Preoperative management to normalize blood pressure followed by tumor removal has proved to be the ideal choice for good prognosis. Multidisciplinary team during preoperative, intraoperative and postoperative are required for successful outcome. Keywords: Bilateral adrenal pheochromocytoma, Bilateral cortical sparing adrenalectomy, Hypertensive crisishttp://www.sciencedirect.com/science/article/pii/S2213576619302532 |
| spellingShingle | Vanessa Lini Gunawan Ketut Suarta Gusti Ayu Putu Nilawati I Made Arimbawa Made Darmajaya Kadek Deddy Ariyanta Pande Putu Yuli Anandasari I Nyoman Budi Hartawan Bilateral adrenal pheochromocytomas in a 14 year-old boy Journal of Pediatric Surgery Case Reports |
| title | Bilateral adrenal pheochromocytomas in a 14 year-old boy |
| title_full | Bilateral adrenal pheochromocytomas in a 14 year-old boy |
| title_fullStr | Bilateral adrenal pheochromocytomas in a 14 year-old boy |
| title_full_unstemmed | Bilateral adrenal pheochromocytomas in a 14 year-old boy |
| title_short | Bilateral adrenal pheochromocytomas in a 14 year-old boy |
| title_sort | bilateral adrenal pheochromocytomas in a 14 year old boy |
| url | http://www.sciencedirect.com/science/article/pii/S2213576619302532 |
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