title: A case of pheochromocytoma presenting as low back pain.
abstract: OBJECTIVE
  This case report describes and discusses a patient with a pheochromocytoma who presented to a chiropractic office with low back pain.
  
  
  METHODS
  The patient is a 51-year-old woman who was self-referred to our chiropractic service with low back pain that appeared to be musculoskeletal in nature. Four days after chiropractic consultation, she collapsed in cardiogenic shock with signs of congestive heart failure, left ventricular dysfunction, and hypotension. Computed tomographic image of the abdomen revealed a right-sided adrenal mass that was confirmed via laboratory analysis to be a pheochromocytoma.
  
  
  RESULTS
  The patient underwent laparoscopic adrenalectomy and made a full recovery. Her initial back symptoms resolved with tumor excision.
  
  
  CONCLUSIONS
  Pheochromocytomas are rare catecholamine-producing tumors of the adrenal glands that can mimic musculoskeletal conditions such as low back pain. Chiropractic physicians should be aware of the various clinical presentations and, when pheochromocytoma is suspected, make prompt referral to medical providers for diagnostic evaluation and treatment.
authors.affiliation: Carlos G Otis Health Care Center Inc, PO Box 216, Townshend, VT 05353, USA. mdavis@gracecottage.org
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Davis
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Bove
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D002395:Catecholamines / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000628:therapy; D026882:Manipulation, Chiropractic / Q000379:methods*; D008875:Middle Aged; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000378:metabolism; D014057:Tomography, X-Ray Computed
chemical_list: D002395:Catecholamines