Malignant Pheochromocytoma Lacking Clinical Features of Catecholamine Excess Until the Late Stage

• Published in: Internal Medicine Vol. 39; no. 10; pp. 820 - 825
• Main Authors: HONDA, Munehiro, UESUGI, Kazuto, YAMAZAKI, Hiroyuki, DEZAWA, Akira, MIZUGUCHI, Kunio, YAMAJI, Tohru, ISHIBASHI, Miyuki
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 2000; Japanese Society of Internal Medicine
• Subjects: Adrenal Gland Neoplasms - blood; Adrenal Gland Neoplasms - diagnostic imaging; Adrenal Gland Neoplasms - pathology; Adrenals. Adrenal axis. Renin-angiotensin system (diseases); Aged; Biological and medical sciences; Bone Neoplasms - blood; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - secondary; Catecholamines - blood; Dopamine - blood; Endocrinopathies; Epinephrine - blood; Fatal Outcome; Humans; hypertension; Hypertension - complications; Magnetic Resonance Imaging; Male; Malignant tumors; Medical sciences; noradrenaline; Norepinephrine - blood; osseous metastasis; paraganglioma; Pheochromocytoma - blood; Pheochromocytoma - diagnostic imaging; Pheochromocytoma - secondary; Radionuclide Imaging; Sweating, Gustatory - complications; Tachycardia - complications; Endocrinopathy; Radionuclide study; Pheochromocytoma; Diseases of the osteoarticular system; Cardiovascular disease; Male; Metastasis; Scintigraphy; Secretory tumor; Histopathology; Complication; Evolution; Sweat; Human; Hypertension; Biochemical analysis; Paraganglioma; Nuclear magnetic resonance imaging; Case study; Symptomatology; Tachycardia; Medical imagery; Norepinephrine; Bone; Elderly
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.39.820

A malignant pheochromocytoma is described in a 71-year-old man. Osseous metastases became manifest 12 years after successful removal of the primary tumor which originated in paraganglionic tissue near the right adrenal gland. Although the patient had no symptoms of catecholamine excess initially, hypertension, tachycardia and excessive sweating appeared several months before his death, concomitantly with a sharp increase in noradrenaline secretion due to an accelerated growth of metastatic tumors. Since there is no histologic criterion of malignancy in this neoplasm, it would be prudent to consider every case of pheochromocytoma as potentially malignant and to follow-up carefully for a long time after removal of the primary tumor. (Internal Medicine 39: 820-825, 2000)