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Spontaneous rupture of adrenal pheochromocytoma with capsular invasion
Author(s) -
ORIKASA KAZUHIKO,
NAMIMA TAKASHIGE,
OHNUMA TETSUTARO,
MUNAKATA MASANORI,
KIMURA NORIKO,
ARAI YOICHI
Publication year - 2004
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2004.00937.x
Subject(s) - medicine , phentolamine , pheochromocytoma , nausea , vomiting , tachycardia , adrenalectomy , anesthesia , abdominal pain , surgery , radiology , propranolol
A 67‐year‐old Japanese man developed a sudden onset of severe right‐side upper abdominal pain, nausea and vomiting. On hospitalization, physical examination revealed sweating, tachycardia, hypertension and the appearance of peripheral vasoconstriction. An urgent computed tomography scan with contrast demonstrated a large hematoma in the right retroperitoneal space. A phentolamine test and an 131 iodine metaiodobenzylguanidine scan suggested pheochromocytoma. An elective right adrenalectomy was successfully performed after pretreatment for sufficient volume replacement with continuous administration of α‐ and β‐adrenergic blocking agents. Pathological diagnosis was an adrenal pheochromocytoma 9.0 × 6.5 cm in diameter with evidence of capsular invasion, which could be associated with a tear in the capsule.