J Korean Endocr Soc.  2006 Oct;21(5):424-427. 10.3803/jkes.2006.21.5.424.

A Case of Spontaneous Rupture of Adrenal Pheochromocytoma

• Kim EJ
• Lim MJ
• Bang BW
• Park HJ
• Hong SB
• Nam MS
• Kim YS
• Choi SJ

• KMID: 1511994
• DOI: http://doi.org/10.3803/jkes.2006.21.5.424

Abstract

Although the spontaneous rupture of a pheochromocytoma is rare, it can be fatal if not promptly diagnosed. Hemorrhagic necrosis of the tumor will require an emergency operation, as this causes intraperitoneal hemorrhaging. Excessive vasoconstriction, tachycardia and labile blood pressure are the signs of a ruptured pheochromocytoma. The standard diagnostic tool of such a condition is an abdominal computed tomographic scan. Although the exact mechanism of the rupture is still unknown, a hemorrhage inside the tumor or a high intra-cortical pressure, due to rapid growth of the tumor, is known to play a major role in the pathogenesis. Herein is reported the case of a 53-year old male patient with a pheochromocytoma and an acute abdomen. The CT scan showed a left adrenal gland mass, with a hemorrhage in the left perirenal space. The patient underwent an emergency adrenalectomy, with the final histopathological diagnosis being that of a pheochromocytoma. Prompt recognition and early surgical intervention can improve outcome.

Keyword

Pheochromocytoma; Rupture

MeSH Terms

Abdomen, Acute
Adrenal Glands
Adrenalectomy
Blood Pressure
Diagnosis
Emergencies
Hemorrhage
Humans
Male
Middle Aged
Necrosis
Pheochromocytoma*
Rupture
Rupture, Spontaneous*
Tachycardia
Tomography, X-Ray Computed
Vasoconstriction

Figure

• 

  Fig. 1 Abdominal CT shows 6.2 × 1.3 cm sized adrenal mass with hemorrhage in left anterior pararenal and perirenal space.

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  Fig. 2 A, Gross findings of tumor shows encaspulated and diffuse areas of hemorrhage; B, Microscopic finding of the tumor. Individual tumor cells have a finely granular basophilic or amphophilic cytoplasm with frequent hyaline globules. The nuclei of the tumor cells are round to oval with prominent nucleolus and occasional intranuclear cytoplasmic inclusion (H&E stain, × 400).

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