A Case of Paroxysmal Pheochromocytoma with Normal Catecholamine Levels.
- Author:
Jung Re YU
1
;
Hyoun Jung CHIN
;
Miyeon KIM
;
Woo Seong JEONG
;
Sang Ah LEE
;
Dae Ho LEE
;
Gwanpyo KOH
Author Information
1. Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea. okdom@medimail.co.kr
- Publication Type:Case Report
- Keywords:
3-iodobenzylguanidine;
Catecholamines;
Pheochromocytoma
- MeSH:
3-Iodobenzylguanidine;
Adrenalectomy;
Catecholamines;
Female;
Headache;
Humans;
Hypertension;
Metanephrine;
Middle Aged;
Pheochromocytoma;
Plasma;
Reference Values;
Sweat;
Sweating;
Vanilmandelic Acid
- From:Korean Journal of Medicine
2012;83(4):503-509
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 53-year-old woman had a 1.7 cm left adrenal mass on an abdominal computed tomography (CT) scan. She presented with paroxysmal headache, palpitation, sweating, and hypertension. The patient was highly suspected of having a pheochromocytoma, but measurements of 24-hour urinary metanephrine, catecholamines, and vanillylmandelic acid were normal. Plasma and urine catecholamine levels were within the normal range even during paroxysmal episodes. A scintigraphic study with 131I-metaiodobenzylguanidine (MIBG) revealed selective concentration of the radiotracer, corresponding to the CT mass. The patient underwent a left adrenalectomy and the pathological examination confirmed the diagnosis of pheochromocytoma. In this report, we describe a rare case of a symptomatic pheochromocytoma with normal catecholamine levels. Our case illustrates that routine nuclear scintigraphy, such as 131I-MIBG, should be performed even in cases with normal hormonal testing for all patients with high clinical suspicion of pheochromocytoma.
