title: Ambulatory blood pressure monitoring in diagnosing a pheochromocytoma of the urinary bladder. A case report.
abstract: A patient is presented in whom the preoperative diagnosis of an intravesical pheochromocytoma was facilitated by noninvasive ambulatory blood pressure monitoring. A fifty-two-year-old Japanese man suffered headache and palpitation after micturition. Cystoscopy revealed an intravesical tumor. To investigate whether his symptoms were associated with an elevation of blood pressure, the authors monitored his ambulatory blood pressure automatically for twenty-four hours. The patient was also instructed to activate the recording manually upon the onset of symptoms. As a result, elevations of blood pressure were apparent following micturition. The twenty-four-hour urinary excretion of norepinephrine was elevated on the day of the blood pressure monitoring. Pheochromocytoma was suspected and was confirmed by histopathologic studies following the operation. Thus, ambulatory blood pressure monitoring may be useful in detecting the transient hypertension induced by micturition, which can provide preoperative evidence of pheochromocytoma of the urinary bladder.
authors.affiliation: Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Fujishima
authors.forename: I
authors.initials: I
authors.lastname: Abe
authors.forename: S
authors.initials: S
authors.lastname: Kaseda
authors.forename: T
authors.initials: T
authors.lastname: Koga
authors.forename: H
authors.initials: H
authors.lastname: Hirano
authors.forename: T
authors.initials: T
authors.lastname: Hamada
authors.forename: H
authors.initials: H
authors.lastname: Oniki
authors.forename: K
authors.initials: K
authors.lastname: Onoyama
authors.forename: M
authors.initials: M
authors.lastname: Fujishima
mesh_terms: D018660:Blood Pressure Monitoring, Ambulatory; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000652:urine; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D009638:Norepinephrine