Ganglioneuromas (GNs) are benign tumors that originate from neural crest cells, composed mainly of mature ganglion cells. These tumors, which are usually hormonally silent, tend to be discovered incidentally on imaging tests and occur along the paravertebral sympathetic chain, from the neck to the pelvis and occasionally in the adrenal medulla. Rarely, GNs secrete catecholamines.1 Adrenal GNs occur most frequently in the fourth and fifth decades of life, whereas GNs of the retroperitoneum and posterior mediastinum are usually encountered in younger adults.2 Adrenal GNs are commonly hormonally silent and asymptomatic; even when the lesion is of substantial size.3We report an incidentally detected asymptomatic case of an adrenal ganglioneuroma with mildly elevated urinary catecholamine levels in an elderly male. After preoperative alpha blockade, the patient underwent open right adrenalectomy. Upon microscopic examination, the right adrenal mass proved to be a ganglioneuroma, maturing type and the immunohistochemistry examination showed immunoreactivity to synaptophysin, chromogranin, and CD 56, while S100 was strongly positive at the Schwannian stroma. Following resection, catecholamine levels normalized, confirming the resected right adrenal ganglioneuroma as the source of the catecholamine excess. This case represents a rare presentation of catecholamine-secreting adrenal ganglioneuroma in the elderly.
Adrenal Glands ; Catecholamines ; Ganglioneuroma

A 36-year-old man visited Yeungnam University Hospital with a sudden onset of palpitation, headache, and was found to be hypertensive. Chest radiography showed a 6 cm sized mass lesion on the posterior mediastinum. A biochemical study showed elevated levels of catecholamines. An I-123 metaiodobenzylguanidine scan revealed a hot uptake lesion on the posterior mediastinum. The patient was prepared for surgery with alpha and beta blocking agents. Two months later, we removed the tumor successfully. A histological study proved that the resected tumor was mediastinal pheochromocytoma. Functional mediastinal pheochromocytomas are rare. Therefore, we reported the case with a literature review.
Catecholamines ; Headache ; Humans ; Hypertension ; Mediastinum ; Pheochromocytoma ; Thorax

The adrenal ganglioneuroma was rare benign tumor that arise from mature sympathetic ganglion cells, located within the substance of the adrenal medulla or along the sympathetic chain. It may secrete catecholamines, represent endocrine symptoms. Nonfunctional growths remain silent until they reach large size. They are usually discovered incidentally. Herein we report a case of left adrenal ganglioneuroma that was incidentally discovered.
Adrenal Medulla ; Catecholamines ; Ganglia, Sympathetic ; Ganglioneuroma*

Exraadrenal paragangliomas are rare tumors of a neural crest origin. Their preoperative diagnosis can be suspected from the clinical history and biochemical examination of the catecholamines or their metabolic by-products. Surgery is the mainstay of therapy, but surgical removal makes an additional problem for the repair of the ureteral defect if a paraganglioma is located near the ureter or if it encloses the ureter. The ureteral repair often poses a therapeutic dilemma, and especially when the ureteral defect is too extensive to be repaired with traditional methods. We report here on a case of successful replacement with using appendix for the repair of a long ureteral defect that was caused by a retroperitoneal paraganglioma.
Appendix* ; Catecholamines ; Diagnosis ; Neural Crest ; Paraganglioma* ; Ureter*

'Takotsubo cardiomyopathy' or 'stress-induced cardiomyopathy' is a newly described clinical entity that's characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis in the absence of any angiographic feature of significant coronary artery disease. The cause of takotsubo cardiomyopathy is unclear, but catecholamines probably play a role in the genesis of takotsubo cardiomyopathy. We report here on two cases of takotsubo cardiomyopathy that occurred during ICU care.
Catecholamines ; Coronary Artery Disease ; Takotsubo Cardiomyopathy

Ganglioneuroma is a rare benign tumor originating from the neural crest cells. It occurs most commonly in the retroperitoneum and posterior mediastinum and is often found in the neck or pelvis. It may be detected incidentally or detected by pressure effects on the adjacent structures due to its slow growth. However, some functional tumors may secrete catecholamines and present with some clinical symptoms. Complete surgical excision is the treatment of choice. We describe here a case of a retroperitoneal ganglioneuroma which was removed completely by surgery. We review the literature and discuss the clinical features of a ganglioneuroma.
Catecholamines ; Ganglioneuroma ; Mediastinum ; Neck ; Neural Crest ; Pelvis

Pheochromocytomas presents with variable clinical manifestations. Cardiomyopathy caused by a pheochromocytoma is well known. We report the case of a 62-year-old woman with recurrent left ventricular dysfunction, who was subsequently found to have a pheochromocytoma. The patient had two different patterns of cardiomyopathy. Patients with a cardiomyopathy, of non-specific origin, should have a pheochromocytoma ruled out.
Cardiomyopathies ; Catecholamines ; Female ; Humans ; Middle Aged ; Pheochromocytoma ; Ventricular Dysfunction, Left

Paraganglioma is one of the pheochromocytomas, and this arises in the extra-adrenal tissue. It is a rare tumor of neural crest origin; it accounts for at least 10% of all the pheochromocytomas. Paragangliomas produce catecholamines and on the basis of this, they are classed as either functional or nonfunctional. We report here on our experience with laparoscopic removal of functional paragangliomas of the pelvic cavity and we include a brief review of literatures.
Catecholamines ; Laparoscopy ; Neural Crest ; Paraganglioma* ; Paraganglioma, Extra-Adrenal ; Pelvis ; Pheochromocytoma

No abstract available.
Catecholamines* ; Female ; Labor Stage, Second* ; Parturition* ; Plasma* ; Pregnancy ; Supine Position*

BACKGROUND: A decreased level of serum arginine vasopressin(AVP) and an increased sensitivity to an exogenous AVP is expected in patients with septic shock who often require a high infusion rate of catecholamines. The goal of the study was to determine whether an exogenous AVP infusion to the patients with septic shock would achieve a significant decrement in infusion rate of catecholamine vasopressors while maintaining hemodynamic stability and adequate urine output. METHODS: Eight patients with septic shock who require a high infusion rate of norepinephrine had received a trial of 4-hour AVP infusion with simultaneous titration of norepinephrine. Hemodynamic parameters and urine output were monitored during the AVP infusion and the monitoring continued up to 4 hours after the AVP infusion had stopped. RESULTS: Mean arterial pressure showed no significant changes during the study period(p=0.197). Norepinephrine infusion rate significantly decreased with concurrent AVP administration(p=0.001). However, beneficial effects had disappeared after the AVP infusion was stopped. In addition, hourly urine output showed no significant changes throughout the trials(p=0.093). CONCLUSION: Concurrent AVP infusion achieved the catecholamine vasopressor sparing effect in the septic shock patients, but there was no evidence of the improvement of renal function. Further study may be indicated to determine whether AVP infusion would provide an organ-protective effect to the septic shock patients.
Arginine* ; Arterial Pressure ; Catecholamines ; Hemodynamics ; Humans ; Norepinephrine ; Shock, Septic*