Pheochromocytoma and tetralogy of Fallot: a rare but potentially dangerous combination.
OBJECTIVE
To describe a case of pheochromocytoma (PHEO) with tetralogy of Fallot (TOF) and discuss the difficulties encountered during the management of this patient, with a review of the literature.


METHODS
We report the clinical course, imaging, and management issues of our patient and review relevant literature.


RESULTS
A 14-year-old female who was known to have TOF presented with classical paroxysmal symptoms and worsening dyspnea. She was diagnosed as having epinephrine-secreting PHEO based on biochemical, radiologic, and functional imaging. She was treated with an α-1 blocker for control of paroxysms but developed severe cyanotic spells. She required addition of a calcium-channel blocker for control of the paroxysms and underwent successful cardiac repair.


CONCLUSIONS
Treatment of the combination of cyanotic congenital heart disease (CCHD) and PHEO requires an individualized and multidisciplinary approach with judicious use of available medications. This is the first case of uncorrected TOF and epinephrine-secreting PHEO. Our case also reiterates the need for further studies to better understand the pathophysiologic link between PHEO/paraganglioma and CCHD.
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Rajeev
R
Kasaliwal
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Vijaya
V
Sarathi
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Reshma
R
Pandit
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Sweta R
SR
Budyal
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Amol
A
Bukan
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Harshal
H
Kakade
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Varsha S
VS
Jagtap
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Anurag R
AR
Lila
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Tushar
T
Bandgar
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Padmavathy S
PS
Menon
Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Nalini S
NS
Shah