Six Cases of Phaeochromocytoma with Unusual Clinical Manifestations

Abstract

Phaeochromocytoma was described by De Courcy (1953)

Hypertensive crisis inducing rhabdomyolysis during laparoscopic resection of a large pheochromocytoma: a case report

“…[2][3][4] It is plausible that, in our patient, massive catecholamine release manifested itself as severe intraoperative hypertension, producing severe vasoconstriction and thus provoking initial ischemia to muscle tissue early in the surgery. This insult, in combination with mostly left-sided muscle compression exacerbated by obesity, the lateral decubitus position, and prolonged, transabdominal, retroperitoneal laparoscopic surgery, resulted in rhabdomyolysis.…”

“…1 Rarely, pheochromocytomas trigger spontaneous rhabdomyolysis, which is thought to be caused by the severe vasospasm and ensuing muscle ischemia during hypertensive crisis. [2][3][4] The present case is to date, the first description of the intraoperative occurrence of this phenomenon. Prolonged laparoscopic resection of a large pheochromocytoma was complicated by severe hypertension followed by intraoperative hyperkalemia as a first sign of rhabdomyolysis.…”

Phaeochromocytoma as a cause of gastro-intestinal distension

“…Gilliland & Daniel (1951) reported a 29-year-old man whose vomiting and severe abdominal pain was due to haemorrhage into the tumour. One of the patients reported by Leather et al (1962) had suffered repeated attacks of abdominal pain and vomiting, simulating cholecystitis. Cholecystectomy was performed prior to the diagnosis of phaeochromocytoma being made, and the tumour was later removed with symptomatic relief.…”

“…While paroxysmal hypertension with vasomotor instability, or sustained hypertension, may suggest the diagnosis, less familiar features may distort the picture. Those recorded include paroxysmal hypotension (Gjol, Dybkaer & Funder, 1957;Richmond, Frazer & Millar, 1961;Hamrin, 1962;Leather et al, 1962), a typical hyperthyroidism (Davies, 1952), glycosuria, or even diabetes mellitus (Freedman et al, 1958) and urinary retention (Barnet et al, 1950;Baird & Cohen, 1954). There is a well-documented association with thyroid carcinoma (Williams, 1965) and with neurofibromatosis (Glushien, Mansuy & Littman, 1953 Seward, 1954) and from cardiac arrhythmia (Durant & Soloff, 1962).…”

Phaeochromocytoma in Children

“…Cases of phaeochromocytoma may also present with profound hypotension or with hypotensive attacks quite apart from operation. The difficulty in diagnosis in such cases has been emphasized recently by Leather, Shaw, Cates and Milnes Walker (1962) who refer to the published material on this subject and discuss the possible mechanism. In a personal communication, Professor Peart has recommended the use of dibenzaline orally in doses 10-20 mg. three times daily in the pre-operative control of adult patients with phaeochromocytoma.…”