title: Spontaneous rupture of adrenal pheochromocytoma with capsular invasion.
abstract: A 67-year-old Japanese man developed a sudden onset of severe right-side upper abdominal pain, nausea and vomiting. On hospitalization, physical examination revealed sweating, tachycardia, hypertension and the appearance of peripheral vasoconstriction. An urgent computed tomography scan with contrast demonstrated a large hematoma in the right retroperitoneal space. A phentolamine test and an 131iodine metaiodobenzylguanidine scan suggested pheochromocytoma. An elective right adrenalectomy was successfully performed after pretreatment for sufficient volume replacement with continuous administration of alpha- and beta-adrenergic blocking agents. Pathological diagnosis was an adrenal pheochromocytoma 9.0 x 6.5 cm in diameter with evidence of capsular invasion, which could be associated with a tear in the capsule.
authors.affiliation: Department of Urology, Tohoku Rosai Hospital, Sendai, Japan. korikasa@bc4.so-net.ne.jp
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Orikasa
authors.forename: Takashige
authors.initials: T
authors.lastname: Namima
authors.forename: Tetsutaro
authors.initials: T
authors.lastname: Ohnuma
authors.forename: Masanori
authors.initials: M
authors.lastname: Munakata
authors.forename: Noriko
authors.initials: N
authors.lastname: Kimura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000628:therapy; D000368:Aged; D006801:Humans; D008297:Male; D009325:Nausea / Q000209:etiology; D009361:Neoplasm Invasiveness; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000628:therapy; D012422:Rupture, Spontaneous; D014839:Vomiting / Q000209:etiology