A case of a ruptured pheochromocytoma with an intratumoral aneurysm managed by coil embolization.
Although the spontaneous rupture of adrenal pheochromocytoma is rare, it can be lethal because it can induce serious changes in the circulation. We describe a 32 year old man with bilateral pheochromocyroma presenting as abdominal pain. In the emergency room, an abdominal MRI showed an aneurysmal vessel in the right adrenal mass and accompanying hemorrhage around the tumor capsule. The bleeding site was found by transfemoral abdominal angiography. Coil embolization was done in the bleeding vessels, specifically branches of the right adrenal artery. The hemorrhage was successfully controlled and vital signs of the patient were restored. Following emergency care, biochemical and imaging studies showed compatible findings of a bilateral adrenal pheochromocytoma. Postoperative histologic findings confirmed these observations. A ruptured pheochromocytoma should be considered as a cause of acute abdomen in cases of a concomitant adrenal mass. Intratumoral aneurysmal bleeding may be a cause of ruptured tumor, and careful angiographic intervention will help to ensure safe control of bleeding in such an emergency situation, even in cases of bilateral tumor.
Park
Ji-Hyun
JH
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University Medical School, Chonju, Korea.
Kang
Kyung-Pyo
KP
Lee
Sung-Joong
SJ
Kim
Chong-Hwa
CH
Park
Tae-Sun
TS
Baek
Hong-Sun
HS
D000005:Abdomen / Q000473:pathology; D000006:Abdomen, Acute / Q000209:etiology; D000310:Adrenal Gland Neoplasms / Q000098:blood supply* / Q000473:pathology; D000311:Adrenal Glands / Q000098:blood supply / Q000000981:diagnostic imaging; D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000175:diagnosis / Q000209:etiology*; D000792:Angiography; D001158:Arteries; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010673:Pheochromocytoma / Q000098:blood supply* / Q000473:pathology; D012187:Retroperitoneal Space