[Spontaneous rupture of the spleen disclosing pheochromocytoma].
The authors report a case of spontaneous rupture of spleen inaugurating the symptomatology of a pheochromocytoma. After presenting the observation, clinical problems are considered with a deceptive abdominal symptomatology and myocardial ischemia that could be part of an "adrenergic myocarditis"; the mechanism of ruptured spleen is analyzed. The diagnosis approach is discussed through a reliability study of various explorations: computed tomography has a sensitivity ranging from 93 to 97% which approaches 100% when associated with magnetic resonance, methyl-iodo-benzyl-guanidine scanning seems to be provided with similar reliability. During checking up for pheochromocytoma spreading, ectopic location was not found, but a cold thyroid nodule was detected which allowed suspecting a SIPPLE syndrome. The three-stage surgical approach was required by symptomatology, hemostasis splenectomy, lateral pheochromocytoma excision after a short preparation by blocking alpha and beta, and then total thyroidectomy after extemporaneous confirmation of the existence of a medullary carcinoma of the thyroid. This pathologic association leading to a SIPPLE syndrome is listed as part of the multiple endocrine neoplasias of type II (MEN II).
Carles
J
J
Service de Chirurgie générale et vasculaire, Hôpital Pellegrin Tondu, Bordeaux.
Guegan
H
H
Crozat
T
T
Janvier
G
G
Riant
T
T
Videau
J
J
D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D012422:Rupture, Spontaneous; D013158:Splenic Diseases / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
Rupture spontanée de rate révélant un phéochromocytome. A propos d'un cas.