title: An autopsy case of bilateral adrenal pheochromocytoma-associated cerebral hemorrhage.
abstract: The autopsy findings of a 30-year-old woman who died of cerebral hemorrhage induced by bilateral adrenal pheochromocytoma are presented. The cerebral hemorrhage was shown on the left cerebral hemisphere widely. Her both adrenal glands were severe swelling, and their parenchyma was occupied by a dark red-brown tumorous positive for chromogranin A. The serum catecholamine and their metabolite, vanillylmandelic acid (VMA) levels were markedly high. Furthermore, cardiac hypertrophy and sclerosis of the arteries of various organs had progressed, suggesting an influence of persistent endocrinal hypertension. The measurement of serum VMA level was thought to be valuable for a postmortem diagnosis of pheochromocytoma. Bilateral adrenal pheochromocytoma may have excessively secreted catecholamine and subsequently caused secondary hypertension, leading to cerebral hemorrhage.
authors.affiliation: Department of Forensic Medicine, Tokyo Medical University, Tokyo 160-8402, Japan. mizukamh@tokyo-med.ac.jp
authors.forename: Hajime
authors.initials: H
authors.lastname: Mizukami
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hara
authors.forename: Masamune
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Mori
authors.forename: Fumi
authors.initials: F
authors.lastname: Kuriiwa
authors.forename: Tatsushige
authors.initials: T
authors.lastname: Fukunaga
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000473:pathology*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000450:Aldosterone / Q000097:blood; D001158:Arteries / Q000473:pathology; D001161:Arteriosclerosis / Q000473:pathology; D006332:Cardiomegaly / Q000473:pathology; D002395:Catecholamines / Q000097:blood; D002543:Cerebral Hemorrhage / Q000473:pathology*; D023921:Coronary Stenosis / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D010673:Pheochromocytoma / Q000473:pathology*; D012598:Sclerosis / Q000473:pathology; D014642:Vanilmandelic Acid / Q000097:blood
chemical_list: D002395:Catecholamines; D000450:Aldosterone; D014642:Vanilmandelic Acid; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone