Arterial Hypertension Syndrome in Pheocromocytoma and Non-Functioning Adrenocortical Adenoma

Abstract

Introduction. The syndrome of arterial hypertension (AH) can be in patients with functioning and non-functioning masses of the adrenal glands which requires a thorough examination to exclude secon¬dary AH of origin. Aim. Identification of clinical, laboratory and radiological features of the AH syndrome in pheochromocytoma (PCC) and adrenocortical adrenal adenoma (incidentaloma). Materials and methods. A retrospective analysis of the clinic, biochemical, hormonal, radiological methods of examination was carried out in 15 patients referred for surgical treatment with a diagnosis of pheochromocytoma. During the postoperative histological examination of the removed masses of the adrenal glands, the diagnosis of PCC was confirmed in 8 out of 15 patients, in 7 patients instead of PCC, adrenocortical adenoma of was diagnosed. Results. Comparative analysis of the results of clinical, laboratory and radiological examination of patients with PCC and non-functioning adrenocortical adenoma with arterial hypertension syndrome showed that arterial hypertension syndrome in PCC has the following features: a crisis course of hypertension with its characteristic symptoms (headache, tremor, profuse sweating, palpitations), passing without treatment with the development of severe weakness after the crisis. Patients with PCC, compared with patients with adrenocortical adenoma, had a lower body mass, high levels of metanephrine, and on computed tomography (CT), the tumors were larger with high contrast uptake in the unenhanced and delayed phases. The reasons for the overdiagnosis of PCC in patients with adrenocortical adenoma in the presence of hypertension were: underestimation of clinical manifestations and an increase in the level of normetanephrine in daily urine, as well as a slight increase in the unenhanced density of contrast uptake on CT in 2 of 7 patients.