Coexistence of pheochromocytoma with abdominal aortic aneurysm: An untold association

Abstract

Pheochromocytomas have been described in association with rare vascular abnormalities, most common of them being renal artery stenosis. A 45-year-old woman was admitted to our hospital with complaints of headache, sweating, anxiety, dizziness, nausea, vomiting and severe hypertension. For the last several days, she was having a dull aching abdominal pain with a palpable, pulsatile, expansile and non-tender mass in the epigastric region. Hypertension was confirmed biochemically to result from excess catecholamine production. Abdominal computed tomography revealed the presence of a right adrenal pheochromocytoma. Magnetic resonance imaging of the abdomen demonstrated an abdominal aortic aneurysm (AAA) of maximum transverse diameter of 4.5 cm with 3 cm lumen. Surgical removal of pheochromocytoma resulted in normalization of blood pressure to normal. Because of the asymptomatic 4.5 cm aneurysm, our patient was advised for periodic follow-up. To our belief, this is the first such case report emanating from India, citing this rare association between pheochromocytoma and AAA. It is concluded that when the two diseases occur simultaneously, both must be diagnosed accurately and treated adequately. Possible mechanisms of such an uncommon association are also discussed.

Norepinephrine Type Pheochromocytoma With Concomitant Aortic Aneurysms: A Distinctive Association

“…There are few reports in the literature that propose an association between pheochromocytoma and AAA [7,8]. Herein, we support those few and, uniquely, report the first norepinephrine type (NE-type) pheochromocytoma coexisting in association with diffuse AAs.…”

Ongebruikelijk voorkomen van een feochromocytoom en niet-geruptureerd aneurysma van de abdominale aorta bij een mannelijke yorkshireterriër

“…The present case reveals the coexistence of an AAA and a large tumor (pheochromocytoma) in the left adrenal gland of a six-year-old, male Yorkshire terrier. The simultaneous occurrence of an AAA with a pheochromocytoma has been previously reported to be uncommon in humans (Kota et al, 2013).…”

“…Canine cases of AAAs have been associated with systemic fungal disease (Gershenson et al, 2011;Murata et al, 2015), spirocercosis (van der Merwe et al, 2008;Kirberger et al, 2013), and familial inheritance in Leonberger dogs (Chetboul et al, 2003). The coexistence of an AAA with a pheochromocytoma has been previously reported as uncommon in humans (Kota et al, 2013). The aim of this case report is to discuss the unusual occurrence of a concurrent large unruptured abdominal aortic aneurism (AAA) and a pheochromocytoma in a male Yorkshire terrier dog.…”

Abdominal Aortic Aneurysm and Pheochromocytoma

“…In one relatively selected review of 50 patients with pheochromocytoma, one had concurrent AAA which did not require intervention [7]. It has been theorized that the presence of pheochromocytoma increases the risk of AAA development and rupture [3,8]. Concurrent presentation has included in an asymptomatic fashion, as in our case, with rupture, and with "occult" pheochromocytoma which required post AAA repair study and resection [7][8][9][10].…”

“…Women have more technically challenging anatomy, are more likely to require open repair, and have increased incidence of endoleaks and limb occlusion due to smaller length and diameter of the proximal landing zone ("neck") [1]. Pheochromocytoma, a tumor of chromaffin cells, is present in < 1% of patients with hypertension [3].…”