Pheochromocytoma, polycythemia, and venous thrombosis.
Polycythemia is rarely associated with pheochromocytoma. A patient with a 22-year history of malignant pheochromocytoma is presented in whom major complications developed as a result of long-standing polycythemia, apparently due to secretion of erythropoietin by the tumors. Despite attempts to reduce tumor burden by surgery, chemotherapy, and large doses of I-131-metaiodobenzylguanidine, polycythemia persisted. Extensive venous thrombosis developed requiring hospitalization and anticoagulation. Thus, polycythemia itself may be a cause of major morbidity in patients with pheochromocytoma, and prophylactic measures may be warranted. Review of the 130 patients with benign and malignant pheochromocytoma studied since the introduction of I-131-metaiodobenzylguanidine in 1980 revealed another six patients with hematocrits over 50 but only one had a hematocrit greater than 55 and required regular phlebotomy. In contrast, anemia (hematocrit less than 35) due to variety of causes was present in 18 cases.
Shulkin
B L
BL
Division of Nuclear Medicine, University of Michigan Medical Center, Ann Arbor 48109-0028.
Shapiro
B
B
Sisson
J C
JC
D000008:Abdominal Neoplasms / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D000328:Adult; D004921:Erythropoietin / Q000378:metabolism; D006801:Humans; D008297:Male; D010673:Pheochromocytoma / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D011086:Polycythemia / Q000209:etiology*; D013924:Thrombophlebitis / Q000209:etiology*; D013997:Time Factors
D004921:Erythropoietin