Pheochromocytoma-induced shock: a case report

Ano: 2012 | Volume: 2 | Número: 3

Autores: S. A. Araújo, P. A. S. Carmo, E. Paulino Júnior, I. N. Borges, L. O. S. Rocha

Palavras-chave: pheochromocytoma, shock, autopsy.

Resumo Inglês:

Because of its rarity, together with the variability and nonspecificity of its signs
and symptoms, pheochromocytoma, a tumor arising from chromaffin cells,
creates an unlucky paradox: it is often missed but only rarely found. Besides the
association with arterial hypertension, often in the form of paroxysmal attacks,
pheochromocytoma may also be associated, in up to 40% of cases, with
orthostatic hypotension which, when present, provides a clue to the diagnosis
of the tumor. Far more rare (about 2% of cases) is the clinical presentation
in the form of shock, a possibility that, among other attributes, justifies the
epithet “the great mimic” applied to the neoplasia. The authors report the
case of a 51-year-old hypertensive woman whose death was erroneously
attributed to septic shock. Autopsy disclosed an unsuspected left adrenal
bulky pheochromocytoma with areas of hemorrhage and extensive central
necrosis, pronounced pulmonary edema, left ventricular mural thrombus, and
histological evidence of acute myocardial injury.