Malignant Pheocromocytoma: Rare, Aggressive, but Easily Neglected

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Introduction: Pheocromocytomas are rare neuroendocrine tumors of which only 10% present metastatic disease.

Aim(s): We report a case of an 81-year-old hypertensive patient complaining of dizziness, fatigue and nosebleed.

Materials and methods: Imaging techniques rulled out pulmonary embolism and showed pericardial effusion, loculated ascitis (peritoneal carcinomatosis?), mediastinic adenopathies and two nodules compatible with accessory spleens. The ascitic fluid revealed 1,700 leucocites/uL (1088 neutrophilis/uL) and no neoplastic cells. Moreover, repeated paroxysms of tremor, impressive cyanosis of face, thorax and extremities without hypoxemia, with immensurable arterial pressure were witnessed, self-limited to 30 minutes; the patient denied headaches and dyspnea. He recalled similar episodes during the previous two months.

Conference: 10th Annual ENETSConcerence (2013)

Presenting Author: Ribeiro C

Authors: Ribeiro C, Patrício C, Gaspar C, Pereira R, Silva F,

Keywords: malignant pheocromocytoma, cyanosis, methanephrines, adrenergic crisis ,

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