A Case Of Cystic Pheochromocytoma With Hypertension And Headaches Mimicking A Large Pancreatic Cystic Tumor

Satoshi Yamagata, MD, PhD; Kazunori Kageyama, MD, PhD; Ayami Nomura, MD; Shingo Murasawa, MD, PhD; Masaru Ogasawara, MD, PhD; Toshiaki Kawaguchi, MD, PhD; Yasuaki Tazawa, MD, PhD; Yoshiji Ogawa, MD, PhD

AACE Clinical Case Reports (Jan 2017)

A Case Of Cystic Pheochromocytoma With Hypertension And Headaches Mimicking A Large Pancreatic Cystic Tumor

Satoshi Yamagata, MD, PhD,
Kazunori Kageyama, MD, PhD,
Ayami Nomura, MD,
Shingo Murasawa, MD, PhD,
Masaru Ogasawara, MD, PhD,
Toshiaki Kawaguchi, MD, PhD,
Yasuaki Tazawa, MD, PhD,
Yoshiji Ogawa, MD, PhD

Affiliations

Satoshi Yamagata, MD, PhD: From the 1Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan; Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan; Address correspondence to Dr. Satoshi Yamagata, Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
Kazunori Kageyama, MD, PhD: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
Ayami Nomura, MD: From the 1Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan
Shingo Murasawa, MD, PhD: From the 1Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan
Masaru Ogasawara, MD, PhD: Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan.
Toshiaki Kawaguchi, MD, PhD: Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan.
Yasuaki Tazawa, MD, PhD: From the 1Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan
Yoshiji Ogawa, MD, PhD: From the 1Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan

Journal volume & issue: Vol. 3, no. 2
pp. e129 – e133

Abstract

Read online

ABSTRACT: Objective: Cystic pheochromocytomas can become enlarged without abdominal symptoms and can potentially be confused with other abdominal cystic tumors.Methods: We report here a case of a 45-mm cystic pheochromocytoma that was initially considered a pancreatic cystic tumor. The patient had a 4-year history of treatment for hypertension and occasional headaches. Left cystic pheochromocytoma was diagnosed based on excessive catecholamine levels, 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT), and 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy.Results: Left adrenalectomy ameliorated the patient's hypertension and headache. Pathologic findings showed an enlarged cyst with an irregular, thick wall adherent to the normal adrenal tissues.Conclusion: A large cystic pheochromocytoma can be misdiagnosed as a large pancreatic cystic tumor. CT and magnetic resonance imaging (MRI) are less important in excluding the possibility of pheochromocytoma than biochemical evaluation. When adrenal glands are not identified on CT or MRI, 18F-FDG PET/CT or 123I-MIBG scintigraphy should be considered.

Published in AACE Clinical Case Reports

ISSN: 2376-0605 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.journals.elsevier.com/aace-clinical-case-reports

About the journal