Bilateral adrenal pheochromocytomas in a 14 year-old boy

A B S T R A C T Introduction: Pheochromocytomas are catecholamine-secreting tumors arise from chromaffin cells of the adrenal medulla. Classical symptoms include palpitations, headaches, sweating and paroxysmal hypertension as a result of elevated catecolamine production. This case report aims to describe the clinical presentation, management and outcome of the phechromocytomas. Case: A 14 year-old boy came with hypertensive crisis (blood pressure 220/140 mmHg), recurrent tension headache, excessive sweating, palpitation and weight loss during the last 1 year. Twenty four hour urinary catecholamine level was normal. Abdominal CT scan confirmed the suspicion of pheochromocytoma. After having preoperative treatment with nicardipine infusion, oral nifedipine and captopril, bilateral cortical sparing adrenalectomy was done. Nicardipine infusion was administered to maintain the blood pressure during surgery. Histopathology confirmed the diagnosis of adrenal pheochromocytoma Adrenocortical was preserved. Complete resolution of hypertension was achieved gradually after one month. Conclusion: Pheochromocytomas is a rare disease which may lead to a life-threatening hypertension as a result of elevated catecolamine production. Initial recognition and appropriate management of pheochromocytomas are important. Preoperative management to normalize blood pressure followed by tumor removal has proved to be the ideal choice for good prognosis. Multidisciplinary team during preoperative, intraoperative and postoperative are required for successful outcome.