骨质内多发性嗜铬细胞瘤一例

患者女,33,岁以左耳后肿块1年,左胸痛半年伴头痛2个月,于1988年12月1日入院。1年前发现左耳后有一黄豆大小肿块,逐渐增大,有压痛。半年前感左侧胸壁疼痛,局部逐渐突起。2个月前出现持续性头痛,测血压右上肢18.7～24.0/13.4～16.0kPa,服复方降压片和硝苯吡啶血压可短暂下降,头痛减轻。以后头痛逐渐加重并伴心悸,半月前出现视物不清。     

嗜铬细胞瘤一例报告

嗜铬细胞瘤以血压增高和代谢紊乱的综合征群为其临床特点,在诊断上除根据临床症状外,尚需特殊的药物试验,实验室检查和X线造影来确诊。我院曾遇到一例嗜铬细胞瘤,由于对其临床特点认识不足,术前误诊。术中根据肿瘤的特点、探     

膀胱嗜铬细胞瘤一例

膀胱嗜铬细胞瘤是一种较罕见的嗜铬细胞瘤,国内少有报道,我院于1999年8月诊治了1例膀胱嗜铬细胞瘤,现报道如下:1　临床资料　　患者女性,34岁,因排尿后心悸、头痛、四肢发冷伴血压阵发性增高7年,加重20天入院。自述每次小便时血压升高至170～210/100～140mmHg,(1mmHg=0.133kPa),小便后约5分血压自行恢复正常水平,即110～120/70～80mmHg。入院时心电图、X线胸片和心脏超声心动图大致正常。超高速计算机断层摄影术示:左侧肾上腺形态较丰满,右侧肾上腺形态无异常。腹部超声:膀胱左侧壁探及1.8cm×0.8cm呈中等均匀回声的异常占位性病变。膀胱…     

嗜铬细胞瘤误诊一例

正1临床资料患者女性,64岁。因"剑突下疼痛伴胸闷气促1d"于2016年4月16日入院。患者入院前1d突发剑突下剧烈疼痛,伴胸闷、气促、恶心、呕吐、畏寒、发热,体温最高达38.4℃,于我院急诊科就诊,复测体温38.3℃,血压166/119mm Hg(1 mm Hg=0.133kPa),心电监护提示氧饱和度88%;血气分析示:pH 7.199,血乳酸7.3mmol/L;心电图提     

异位嗜铬细胞瘤一例

异位嗜铬细胞瘤一例河北省易县人民医院冯桂山，沈太安，王久让，吴国新，张爱芹，祖海英１临床资料患者４０岁，女性。因间断偏头痛７年，发现上腹部肿物３天入院。７年前突然出现胸闷、心悸、剧烈头痛、恶心、黑蒙、晕倒１次，未经特殊治疗好转。此后反复发作４次，症状...     

不典型嗜铬细胞瘤一例

嗜铬细胞瘤以腰痛为首发症状伴以急性左心衰竭者较少见且易误珍。现将经手术及病理证实的一例报道如下: 患者女性,30岁。因持续性左侧腰痛伴心悸、憋气、不能平卧,于1988年5月11日入院。10日凌晨,在睡眠中突感左侧腰部持续胀痛并阵发加剧,几小时后感头痛、恶心,去某医院就诊。当时测血压25.3/16kPa(190/120mmHg),ECG示窦性心律及阵发性房颤。窦率60次/min、房颤室率160次/min,ST     

腹部异位嗜铬细胞瘤一例

1 临床资料 患者男性,16岁,主因"发作性腹痛伴头晕10余年,左下肢酸痛乏力2年"入院。患者10年前上体育课时出现左下腹疼痛,伴头晕、头痛、恶心、呕吐,后常于劳累时发作,每年1-2次,未测血压。4年前因腹痛再次就诊时测血压210/100 mmHg(1 mmHg=0.133 kPa),常规降压治疗后,血压仍为140-180/90-110 mmHg,平时无明显畏热、出汗。2年前出现行走50 m     

不典型嗜铬细胞瘤一例

患者女性,26岁,因突发心悸、胸闷、恶心、呕吐、发热1天来我院就诊.查体:血压10.0/6.7kPa(75/50mmHg),体温38℃,心率108次/分,心脏、双肺、腹部检查均未见异常.心电图示Ⅰ、aVL导联ST抬高0.1mV,T波双相;Ⅱ、Ⅲ、aVF导联ST抬高0.1mV,T波双相;Ⅱ、Ⅲ、aVF导联ST下降.因低血压、心电图异常而以“急性心肌炎”收入院.实验室检查:血红蛋白145μg/L,白细胞10.3×10~9/L,乳酸脱氢酶10.7μmol·s~(-1)/L,肌酸激酶296U/L,血清酶及心电图1周后恢复正常.红细胞沉降率及血糖正常,超声心动图及~(201)TL心肌显像均未见异常.经卧床休息、心肌细胞营养治疗,病情无改善.入院后再次无诱因发作心悸、气短     

纵隔嗜铬细胞瘤一例报告

纵隔嗜铬细胞瘤临床较为罕见,现将一例以阵发性高血压伴头痛、出汗为主征,手术摘除证实,(?)访两年病情稳定,扼要报告如下:胡××,男,18岁,学生。住院号96391。1982年12月11日入院,诉3年来经常头痛、心悸、多汗、易饿、烦躁失眠等。当时血压不高。近半年有阵发性搏动性头痛、伴心悸、面色苍白、出汗、血压高达220/120,每次持继5～10分钟,可自行缓解。对降压药无效。患者消瘦,心率80次,律吝,     

Intrapericardial pheochromocytoma: a case report

A patient with a pheochromocytoma located intrapericardially is described. 131I-labeled metaiodobenzylguanidine scintigraphy was helpful in locating the tumour. The operation and postoperative course were uneventful.     

Intrapericardial pheochromocytoma: a case report and review of the literature

A patient with intrapericardial pheochromocytoma is presented and the literature on this subject is reviewed. The patient was a 45-year-old housewife who was first referred to Keio University hospital in February 1981 for a 6-year-history of headaches, palpitations and excessive sweating. An episode of hypertensive crisis was observed during surgery for myoma uteri 3 months before her admission. On physical examination, the patient was a normal-appearing, pleasant woman. Supine blood pressure was 130/80 mmHg and standing blood pressure was 124/72 mmHg. Results of routine laboratory studies (including fasting serum glucose and calcium determinations and thyroid function tests) were normal. A 24-hour-urine collection showed VMA level of 10.5 mg and noradrenaline of 809 micrograms. Also repeated measurements of plasma noradrenaline on supine position revealed averages of 2.45 ng/ml. These high levels of catecholamines, clinical manifestations, and provocative tests including a metoclopramide test were strongly suggestive of pheochromocytoma, and further studies for determination of the localization were performed. Results of computed tomography (CT), adrenal scintigraphy using 131I-adosterol and selective venous sampling for catecholamines were equivocal. Then she was followed in an outpatient clinic and treated with alpha- and beta-blocker. In October 1985, she was readmitted to our hospital because of paroxysms which had gradually increased in frequency and severity. Extensive venous sampling in order to determine the localization of the tumor was performed after demonstration of an increased uptake area in the anterior thorax in 131I-metaiodobenzylguanidine scintigraphy. Further, an anterior mediastinal mass was identified in the CT scan of the chest with contrast material. Finally, a thoracic angiogram revealed that the tumor was highly vascular and was fed by the branch of the left internal mammary artery. In January 1986, the patient underwent middle sternotomy with cardiopulmonary bypass. A 4.5 by 3.5 by 3.0 cm soft, dark brown tumor was found on the anterior surface of the heart and excised without difficulty. The tumor seemed to arise from the root of the aorta and main pulmonary artery, and extended inferiorly over the anterior surface of the right ventricle. It was also fed by branches of the right coronary artery. Histologically, the resected tumor was compatible with pheochromocytoma. The tumor content of noradrenaline was 3.34 mg/g wet tissue; however, adrenaline and dopamine were not detected. The postoperative course was uneventful.(ABSTRACT TRUNCATED AT 400 WORDS)     

Intrapericardial pheochromocytoma

Pheochromocytoma is a catecholamine-secreting tumor. Most cases are intra-adrenal, and intrapericardial pheochromocytomas are extremely rare. We report a case of a 30-year-old woman with a seven-year history of hypertension. The concentration of blood noradrenaline was found to be elevated. Chest computed tomography scan showed a limited bulge in the superior border of the right atrium. Magnetic resonance imaging confirmed the existence of a tumor. Coronary arteriography detected a mass near the right atrium, which was nourished by an aberrant branch of the right coronary artery. After preoperative preparation, the patient underwent pericardial tumor resection. Postoperative recovery was uneventful and the patient was successfully discharged 20 days later.     

Intrapericardial pheochromocytoma

A patient with intrapericardial pheochromocytoma is described, and the literature on this subject is reviewed. Iodine 131-labeled metaiodobenzylguanidine scintigraphy was superior to computed tomography in localizing the tumor. This newly introduced method is safe, specific, noninvasive, and may prove to be the method of choice for localizing pheochromocytomas. The patient was prepared for surgery with alpha- and beta-adrenoceptor blocking agents. The tumor was markedly adherent to the posterior wall of the left and right atria. Cardiopulmonary bypass was used to allow excision of the tumor. Hemostasis was attained with difficulty due to marked vascularity of the tumor.     

Bi-directional ventricular tachycardia and pheochromocytoma: a case report

We present the case of a 48 year old woman who was admitted to our university hospital in cardiogenic shock with bi-directional ventricular tachycardia degenerating into polymorphic venricular tachycardia which resolved spontaneously. Investigation revealed healthy coronary arteries but severe left ventricular dysfunction due to akinesia involving the entire base. There was a rapid improvement within several days. The diagnosis of bilateral phaeochromocytoma was made on the biochemistry and CT scan of the adrenals.     

Acute myocardial infarction revealing a pheochromocytoma: a case report

We report a case of a 38-year-old woman with pheochromocytoma admitted to our department for an acute myocardial infarction. The diagnosis of pheochromocytoma was evoked in view of the major pressure variations that appeared secondarily. Pheochromocytoma is mainly medullosurrenal tumour with clinical polymorphism; it can lead to severe cardiovascular disorders. Nevertheless, cardiac involvement is rarely in the foreground. Our clinical case illustrates the importance to evoke the diagnosis of pheochromocytoma in front of atypical manifestations of acute coronary syndrome so as to reduce mortality.     

异位恶性嗜铬细胞瘤一例报道

女性患者, 72岁,主诉因嗜铬细胞瘤术后 4年余,胸腰部疼痛半年,发现血糖升高 1个月于 2003年 3月 6日入院。4年前患者无意中发现腹部肿物并出现烦渴多饮多尿,血糖异常,血压持续升高,多维持在 200 /100mmHg( 1mmHg=0. 133kPa),腹部CT提示腹主动脉旁(左侧)5cm×4cm×3cm类圆形软组织密度影,内有液化、坏死灶。3次 24h尿香草基扁桃酸(VMA)明显升高,分别为 189. 0μmol/L, 192. 8μmol/L和187. 5μmol/L(正常值: 25. 0 ~70. 2μmol/L)。手术切除肿瘤后,血糖恢复正常,血压降至基础水平, 3次 24h尿VMA均正常。病理结果显示嗜铬细胞瘤(…     

Malignant pheochromocytoma. Apropos of a case report

Pheochromocytoma was diagnosed in a male of 38 on the basis of severe and progressive hypertension associated with marked increases in urinary catecholamines and vanilmandelic acid. Left extra-adrenal topography was examined by tomography and confirmed by surgical treatment involving exeresis of the primary tumor and the metastatic latero-aortic lymph nodes, thus corroborating the diagnosis of malignancy. Complementary post-operative radiotherapy was performed on the abdomen. Eighty months later the patient is making good progress.