Yeungnam Univ J Med.  2019 Sep;36(3):254-259. 10.12701/yujm.2019.00213.

Catastrophic catecholamine-induced cardiomyopathy rescued by extracorporeal membrane oxygenation in recurrent malignant pheochromocytoma

• Min D

• KMID: 2460195
• DOI: http://doi.org/10.12701/yujm.2019.00213

Abstract

Pheochromocytoma (PCC) is a rare catecholamine-producing tumor with the incidence in hypertension of 0.1-0.6%. PCC crisis is an endocrine emergency that can lead to hemodynamic disturbance and organ failure such as catecholamine-induced cardiomyopathy. The circulatory collapse caused by it often requires mechanical support. The author reports an unusual case in which a patient who previously underwent surgery for malignant PCC developed catecholamine-induced cardiomyopathy, and successfully recovered using extracorporeal membrane oxygenation.

Keyword

Cardiogenic shock; Cardiomyopathy; Extracorporeal membrane oxygenation; Pheochromocytoma

MeSH Terms

Cardiomyopathies*
Emergencies
Extracorporeal Membrane Oxygenation*
Hemodynamics
Humans
Hypertension
Incidence
Pheochromocytoma*
Shock
Shock, Cardiogenic

Figure

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  Fig. 1. (A) Abdomen-pelvis CT of 11 years ago shows a 9x7 cm sized pheochromocytoma (arrow) in the right adrenal gland. (B) There is no evidence of local recurrence on abdomen-pelvis CT at admission. CT, computed tomography.

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  Fig. 2. (A) No abnormality is seen on chest X-ray at admission. (B) Chest X-ray after 4 hours of admission reveals a rapidly developed bilateral consolidation.

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  Fig. 3. Sacrum magnetic resonance imaging shows a 2.7x2.9x2.8 cm sized well-defined, lobulated, and slightly expansile mass (arrow) at right upper sacral ala.

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  Fig. 4. Positron emission tomography scan shows an increase of uptake in the mass of sacrum.

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  Fig. 5. Histopathologic findings of the sacral mass. There are atypical spindle-shaped tumor cells (hematoxylin and eosin stain, ×100 [A] and ×200 [B]) show synaptophysin (C) and chromogranin (D) positivity (×100).

Reference

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