Unexpected metastatic pheochromocytoma - an unusual presentation.
The classic triad of pheochromocytoma consists of episodic headache, sweating, and tachycardia. General clinicians should be aware, however, that this rare entity might present with a wide spectrum of clinical symptoms. We recently observed a noteworthy case of malignant pheochromocytoma where there was a lack of specific symptoms despite an advanced tumor stage. Malignancy is an important cause of mortality. Reliable diagnosis of malignancy depends upon evidence of local invasion, distant metastases, or recurrence. As in our case, new scintigraphic methods, such as 111-In-pentetreotide scintigraphy (Octreoscan), may occasionally reveal 123-I-metaiodobenzylguanidine-negative distant metastases and help to establish an early diagnosis of malignancy. Tumor size, and perhaps even biochemical profile, may be factors increasing the likelihood of a malignant process and may contribute to early identification of patients at risk.
Birrenbach
Tanja
T
Department of Internal Medicine, University Hospital Bern, CH-3010 Bern, Switzerland.
Stanga
Zeno
Z
Cottagnoud
Philippe
P
Stucki
Armin
A
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004298:Dopamine / Q000652:urine; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D011877:Radionuclide Imaging
D004298:Dopamine