[Pheochromocytoma of the left retroperitoneal paraganglion associated with torsade de pointes: a case report].
A 54-year-old woman developed torsade de pointes with secondary QT prolongation due to hypokalemia and hypomagnesemia. Her serum K and Mg levels were 2.5 mEq/l and 1.5 mg/dl, respectively. This electrolyte imbalance was due to intentional overdosing of metolazone. Attacks of torsade de pointes occurred three times in the intensive care unit and were corrected by intravenous lidocaine administration. Her serum K level was corrected using KCl infusion, restoring the normal QT interval. Routine computed tomography found a left retroperitoneal paraganglioma. Urinary and serum catecholamine examination revealed extremely high values of epinephrine and norepinephrine. The diagnosis was pheochromocytoma in the left retroperitoneal paraganglion. The tumor which was removed measured 70 x 65 x 60 mm in size. Microscopic examination revealed the characteristic patterns of pheochromocytoma.
Kihara
H
H
Department of Internal Medicine, Kihara Cardiovascular Clinic, Asahikawa.
Terai
H
H
Kihara
Y
Y
Kihara
T
T
Takahashi
H
H
Kosuda
A
A
Shimomoto
M
M
Fukunishi
M
M
Tanaka
T
T
D004232:Diuretics / Q000009:adverse effects; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000209:etiology; D008788:Metolazone / Q000009:adverse effects; D008875:Middle Aged; D010233:Paraganglia, Chromaffin; D010673:Pheochromocytoma / Q000175:diagnosis*; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis*; D016171:Torsades de Pointes / Q000209:etiology*; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced
D004232:Diuretics; D008788:Metolazone