Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Pheochromocytoma presenting as recurrent urinary tract infections : a case report | Dolan et al. Journal of Medical Case Reports 2011 5 6 http content 5 1 6 WV journalof medical l rCASE REPORTS CASE REPORT Open Access Pheochromocytoma presenting as recurrent urinary tract infections a case report Roisin T Dolan1 2 Joseph S Butler1 Gerard P McEntee1 Maria M Byrne2 Abstract Introduction Pheochromocytomas are rare potentially fatal neuroendocrine tumors of the adrenal medulla or extra-adrenal paraganglia. Their clinical presentation varies greatly from the classic triad of episodic headache diaphoresis and tachycardia to include a spectrum of non-specific symptomatology. Case presentation A 43-year-old Caucasian woman was referred to us from primary care services with a three-month history of recurrent urinary tract infections on a background of hypertension latent autoimmune diabetes of adulthood and autoimmune hypothyroidism. At 38 years she required insulin therapy. Despite medication compliance and dietary control she reported a recent history of increased insulin requirements and uncontrolled hypertension with concomitant recurrent urinary tract infections. A renal ultrasound examination to rule out underlying renal pathology revealed an incidental 8cm right adrenal mass of both solid and cystic components. A subsequent computed tomography of her abdomen and pelvis confirmed a solid heterogeneous mass consistent with a pheochromocytoma. There were no other features suggestive of multiple endocrine neoplasia. Urinary collection over 24 hours revealed grossly elevated levels of catecholamines and metabolites. Following an open right adrenalectomy our patient s insulin requirements were significantly reduced and her symptoms resolved. Two weeks post-operatively an iodine-131-metaiodobenzylguanidine scintigraphy was negative for residual tumor and metastatic disease. Urinary catecholamine and metabolite concentrations were within the normal range at a follow-up six months later. Conclusion Pheochromocytoma is a rare .
