PHEOCHROMOCYTOMA "THE GREAT IMITATOR". A CASE REPORT castanedafucamila@gmail.com

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PHEOCHROMOCYTOMA "THE GREAT IMITATOR". A CASE REPORT

5

Colombia

Poster with Discussion

Pheochromocytoma is a rare neuroendocrine tumor that originates in the chromaffin cells of the adrenal medulla, it´s a life-threatening disease characterized by a overproduction of catecholamines leading sustained or paroxysmal hypertension, headaches, sweating and palpitations. It occurs most frequently in individuals between 40 and 50 years old. Diagnosis requires biochemical tests (plasma metanephrines) and imaging (CT or MRI). Standard treatment is laparoscopic adrenalectomy, preceded by adrenergic blockade.

We report the case of a 49-year-old female who presented with upper right quadrant abdominal pain. Her medical history was significant for hypertension and hypertensive heart disease. An abdominal CT scan revealed a right adrenal incidentaloma, and subsequent laboratory evaluations confirmed the diagnosis of pheochromocytoma associated with hyperaldosteronism.

Following appropriate preoperative medical management, the patient underwent a laparoscopic adrenalectomy. Intraoperatively, she experienced a hypertensive crisis, which was promptly and effectively managed without major complications. In the immediate postoperative period, her clinical course progressed favorably. The patient was discharged with corticosteroid replacement therapy and antihypertensive medication. At present, she remains asymptomatic and is under multidisciplinary follow-up with endocrinology, internal medicine, and general surgery.

The objective of this case report is to describe an unusual presentation of adrenal pheochromocytoma in a patient with a history of refractory hypertension, who initially presented with symptoms suggestive of an acute abdomen. Additionally, this case highlights that laparoscopic resection is a safe and effective approach for the surgical management of pheochromocytoma.