title: Phaeochromocytoma with hypercortisolism and hypercalcaemia.
abstract: We report a case of phaeochromocytoma associated with hypercortisolism and hypercalcaemia in a 62-year-old man. The patient presented to clinic, with a 3-year history of exertional headaches, and a 4-month history of increasing fatigue, sweating and palpitations, loss of appetite and weight, and sleepiness. He did not have a medical, family or social history that could account for these symptoms. 24 h urinary catecholamines, plasma metanephrines, 24 h urinary cortisol and adjusted serum calcium, were elevated. Overnight low-dose dexamethasone suppression test did not suppress morning plasma cortisol. Serum intact parathyroid hormone and parathyroid hormone-related peptide were low, and adrenocorticotropic hormone was normal. The patient was treated with intravenous 0.9% sodium chloride and disodium pamidronate to control hypercalcaemia. CT showed a 10 cm left adrenal mass. Following inpatient treatment with phenoxybenzamine, he underwent a left adrenectomy and histology confirmed a phaeochromocytoma. Postoperatively, he required long-term steroids for contralateral adrenal suppression. Adjusted serum calcium returned to normal postoperatively.
authors.affiliation: Sheffield Teaching Hospitals, Sheffield, UK.
authors.forename: Ovie
authors.initials: O
authors.lastname: Edafe
authors.affiliation: Department of Endocrinology, Sheffield Teaching Hospitals, Sheffield, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Webster
authors.affiliation: Department of Histopathology, Sheffield Teaching Hospitals, Sheffield, UK.
authors.forename: Malee
authors.initials: M
authors.lastname: Fernando
authors.affiliation: Department of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Ragu
authors.initials: R
authors.lastname: Vinayagam
authors.affiliation: Department of Surgical Oncology, University of Sheffield, Sheffield, UK.
authors.forename: Sabapathy P
authors.initials: SP
authors.lastname: Balasubramanian
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood* / Q000473:pathology / Q000652:urine*; D002118:Calcium / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D006934:Hypercalcemia / Q000097:blood* / Q000473:pathology / Q000652:urine*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000097:blood* / Q000473:pathology / Q000601:surgery / Q000652:urine*
chemical_list: D002118:Calcium; D006854:Hydrocortisone