[Coexistence of renovascular hypertension and pheochromocytoma. Description of 2 clinical cases].
The two unusual clinical cases described here illustrate the importance of correct application of clinical methodology. Two patients, a 55-year-old man and a 50-year-old woman, presented with severe hypertension due to the coexistence of renal artery stenosis and pheochromocytoma. Their symptoms were indicative of renovascular hypertension which was verified by the finding of extremely elevated plasma renin activity and angiographic detection of critical renal artery stenosis. Further consideration of specific clinical findings led to the suspicion of coexisting pathologies: the detection of elevated plasma catecholamine levels and abdominal computed tomography and iodobenzylguanidine imaging confirmed the presence of pheochromocytoma. The first patient repeatedly refused surgical treatment and died after 9 months; the second patient recovered after undergoing combined nephrectomy and tumor removal. These cases underscore the importance of a carefully planned sequence of studies in patients presenting with uncommon or equivocal clinical manifestations, particularly when conclusive diagnosis is essential to successful treatment.
Secchi
M B
MB
Centro per l'Ipertensione Arteriosa, Divisione di Medicina Interna. Ospedale Bassini, Cinisello Balsamo MI.
Bettazzi
L
L
Mancarella
S
S
Loche
G
G
Wu
S C
SC
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D013997:Time Factors
Coesistenza di ipertensione nefrovascolare e feocromocitoma. Descrizione di due casi clinici.