Öz
Pheochromocytoma is a rare tumor that develops from the chromaffin cells of the sympathetic nervous system. Although hypertension is the most common manifestation of pheochromocytoma, it is less common in children than in adults. This condition may be overlooked like in our patient who had an undiagnosed headache for several years. Our patient was admitted to our emergency department due to the increase in headache, which lasted for about 6 years, and a neurological evaluation was performed. Due to the high blood pressure in her follow-up, she was examined further. Abdominal USG revealed a 36x26x27 mm solid lesion in the right adrenal gland with a mild hyperechogenic appearance with a cystic component. With supporting findings in magnetic resonance imaging and high catecholamine levels in blood, she was diagnosed with pheochromocytoma. Our aim in sharing this case is to emphasize the importance of measuring blood pressure in patients accurately and at each examination, evaluating them with percentile charts, and monitoring them closely.
Anahtar Kelimeler
Kaynakça
- 1. Coutant, R., et al., Prognosis of children with malignant pheochromocytoma. Report of 2 cases and review of the literature. Horm Res, 1999. 52(3): p. 145-9.
- 2. Flynn, I.Y.a.J.T., Pathophysiology of Pediatric Hypertension, in Pediatric Nephrology, E.D. Avner, Editor. 2016.
- 3. Fonseca, V. and P.M. Bouloux, Phaeochromocytoma and paraganglioma. Baillieres Clin Endocrinol Metab, 1993. 7(2): p. 509-44.
- 4. Igaki, J., et al., A pediatric case of pheochromocytoma without apparent hypertension associated with von Hippel-Lindau disease. Clin Pediatr Endocrinol, 2018. 27(2): p. 87-93.
- 5. Havekes, B., et al., Update on pediatric pheochromocytoma. Pediatr Nephrol, 2009. 24(5): p. 943-50.
- 6. Kohane, D.S., et al., Case records of the Massachusetts General Hospital. Case 16-2005. A nine-year-old girl with headaches and hypertension. N Engl J Med, 2005. 352(21): p. 2223-31.
- 7. Pekic, S., et al., Intracerebral hemorrhage as a first sign of pheochromocytoma: case report and review of the literature. Endokrynol Pol, 2019. 70(3): p. 298-303.
- 8. Babic, B., et al., Pediatric patients with pheochromocytoma and paraganglioma should have routine preoperative genetic testing for common susceptibility genes in addition to imaging to detect extra-adrenal and metastatic tumors. Surgery, 2017. 161(1): p. 220-227.
- 9. Prabhu, M., et al., Child with bilateral pheochromocytoma and a surgically solitary kidney: Anesthetic challenges. Saudi J Anaesth, 2013. 7(2): p. 197-9.
- 10. Pappachan, J.M., et al., Pheochromocytomas and Hypertension. Curr Hypertens Rep, 2018. 20(1): p. 3.
Öz
Özet
Feokromasitoma sempatik sinir sisteminin kromaffin hücrelerinden gelişen nadir görülen bir tümördür. Hipertansiyon feokromasitomanın en sık bulgusu olmasına rağmen, bu durum çocuklarda erişkinlere göre daha az sıklıkta görülmektedir. Uzun zamandır tanı konulamayan baş ağrısı şikayeti ile başvuran hastamızda gözden kaçırılabilecek bu kliniği değerlendirdik. Hastamız yaklaşık 6 yıldır süren baş ağrısı şikayetinin artması nedeni ile acil servisimize başvurmuş, takibinde nörolojik değerlendirme yapılmıştır. İzleminde kan basıncı yüksekliği saptanması üzerine ileri tetkik edilmiş ve abdominal ultrasonografide sağ sürrenal bezde 36x26x27 mm boyutlarında içerisinde kistik bileşeni bulunan hafif hiperekojen görünümde solid lezyon saptanması, kitlenin manyetik rezonans görüntüleme ve katekolamin yüksekliği ile desteklenmesi ile feokromasitoma tanısı konulmuştur. Olguyu paylaşmamızdaki amacımız hastalarda kan basıncı ölçümünün doğru şekilde ve her muayenede yapılması, persentil çizelgeleri ile değerlendirilmesi ve yakın takibinin önemini vurgulamaktır.
Anahtar Kelimeler
Kaynakça
- 1. Coutant, R., et al., Prognosis of children with malignant pheochromocytoma. Report of 2 cases and review of the literature. Horm Res, 1999. 52(3): p. 145-9.
- 2. Flynn, I.Y.a.J.T., Pathophysiology of Pediatric Hypertension, in Pediatric Nephrology, E.D. Avner, Editor. 2016.
- 3. Fonseca, V. and P.M. Bouloux, Phaeochromocytoma and paraganglioma. Baillieres Clin Endocrinol Metab, 1993. 7(2): p. 509-44.
- 4. Igaki, J., et al., A pediatric case of pheochromocytoma without apparent hypertension associated with von Hippel-Lindau disease. Clin Pediatr Endocrinol, 2018. 27(2): p. 87-93.
- 5. Havekes, B., et al., Update on pediatric pheochromocytoma. Pediatr Nephrol, 2009. 24(5): p. 943-50.
- 6. Kohane, D.S., et al., Case records of the Massachusetts General Hospital. Case 16-2005. A nine-year-old girl with headaches and hypertension. N Engl J Med, 2005. 352(21): p. 2223-31.
- 7. Pekic, S., et al., Intracerebral hemorrhage as a first sign of pheochromocytoma: case report and review of the literature. Endokrynol Pol, 2019. 70(3): p. 298-303.
- 8. Babic, B., et al., Pediatric patients with pheochromocytoma and paraganglioma should have routine preoperative genetic testing for common susceptibility genes in addition to imaging to detect extra-adrenal and metastatic tumors. Surgery, 2017. 161(1): p. 220-227.
- 9. Prabhu, M., et al., Child with bilateral pheochromocytoma and a surgically solitary kidney: Anesthetic challenges. Saudi J Anaesth, 2013. 7(2): p. 197-9.
- 10. Pappachan, J.M., et al., Pheochromocytomas and Hypertension. Curr Hypertens Rep, 2018. 20(1): p. 3.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 25 Mart 2021 |
| Kabul Tarihi | 22 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2021 |