A Case of Pheochromocytoma with Renal Artery Stenosis and Post-Surgical Watery Diarrhea

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Abstract

A 35-year-old woman was admitted to our hospital with the following complaints, headache, sweating, anxiety, dizziness, nausea, vomiting and severe hypertension. The technical images (abdominal CT, scintigraphic octreotide scan and renal arteriography) revealed the presence of a left adrenal pheochromocytoma and stenosis of the renal artery. Ten days following adrenalectomy, watery diarrhea appeared. The long-acting somatostatin analogue octreotide (LAR, 30 mg/month, i.m.), was started, and after 2 weeks diarrhea decreased and gradually disappeared. In conclusion, we were confronted with an unusual case of pheochromocytoma associated with renal artery stenosis and the appearance of watery diarrhea some days after surgical treatment. Treatment with octreotide brought about the remission of diarrhea in this patient.

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A new human chromogranin 'A' immunoradiometric assay for the diagnosis of neuroendocrine tumours

G Bernini, Marcos Moretti, M Ferdeghini … (2001)

We investigated whether plasma chromogranin A (CgA), measured by a new immunoradiometric assay, may be a sensitive and specific marker of phaeochromocytoma and of other neuroendocrine tumours. This study involved 121 patients of whom 20 with phaeochromocytoma, 28 with other neuroendocrine tumours (19 gastroenteropancreatic tumors, 3 medullary thyroid and 6 small cell lung carcinomas), 25 with solid nonfunctioning adrenocortical tumours and 48 with essential hypertension. In addition, 130 normal subjects were taken as controls. Plasma catecholamines were measured by using high-performance liquid chromatography, and CgA by a two-site sandwich immunoradiometric assay involving monoclonal antibodies raised against the unprocessed central domain (145–245) of human CgA. Plasma CgA in controls (49.0 ± 3.1 ng ml–1, mean ± SE) and in essential hypertensives (50.8 ± 3.5 ng ml–1) was lower (P< 0.0001) than in adrenocortical tumours (91.8 ± 13.2 ng ml–1), in phaeochromocytomas (254 ± 49 ng ml–1) and in patients with other neuroendocrine tumours (469 ± 84 ng ml–1). Plasma CgA and catecholamines identified 13 and 18 out of 20 phaeochromocytomas with sensitivity of 65% and 90%, respectively. Combined measurement of both markers improved sensitivity up to 100%. In the other neuroendocrine tumours, CgA was abnormal in 23/28 cases (sensitivity 82%) and in 6 it was the only circulating marker of disease. In gastroenteropancreatic tumours, CgA measurement identified all cases (sensitivity 100%). Specificity of CgA in patients with essential hypertension was 98%. In conclusion, CgA determination showed high sensitivity in identifying gastroenteropancreatic tumours and, in association with catecholamines, in detecting patients with phaeochromocytoma. CgA sometimes appeared to be the only circulating marker of disease. Since the specificity of CgA proved to be excellent, this assay may be useful for diagnosis both of functioning and non-functioning neuroendocrine tumours. © 2001 Cancer Research Campaign http://www.bjcancer.com

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[123I]Metaiodobenzylguanidine and [111In]Octreotide Uptake in Benign and Malignant Pheochromocytomas

E. van der Harst (2001)

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Control of Catecholamine Release and Blood Pressure with Octreotide in a Patient with Pheochromocytoma: A Case Report with in vitro Studies

Nobuyuki Koriyama, Masafumi Kakei, Kazuro Yaekura … (2000)

A 65-year-old male patient with pheochromocytoma, whose hypertensive episodes were uncontrolled using conventional therapy, was successfully treated with octreotide (SMS 201-995). The serum catecholamine level and the urinary excretion of catecholamines decreased after 300 μg/day of octreotide was administered. To clarify the mechanisms of octreotide that lower catecholamine released from a tumor, we studied the in vitro effects of octreotide on membrane potentials and voltage-dependent Ca 2+ channel (VDCC) current using the whole-cell patch-clamp technique in single pheochromocytoma cells dispersed after tumor resection. The action potentials were reversibly inhibited with 10 μ M octreotide. In addition, the VDCC current evoked by depolarized pulses from the holding potential of –60 mV was inhibited with 10 μ M octreotide. Octreotide is useful for controlling blood pressure before surgery in some patients with uncontrolled hypertension caused by a pheochromocytoma.

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Author and article information

Journal

Journal ID (publisher-id): HRE

Journal ID (nlm-ta): Horm Res Paediatr

Journal ID (doi): 10.1159/issn.1663-2818

Title: Hormone Research in Paediatrics

Publisher: S. Karger AG

ISSN (Print): 1663-2818

ISSN (Electronic): 1663-2826

Publication date Subscription-year: 2001

Publication date (Print): 2001

Publication date (Electronic): 15 February 2002

Volume: 56

Issue: 3-4

Pages: 130-133

Affiliations

^aSecond Division of Internal Medicine, Hospital ‘Sandro Pertini’, Rome, and Departments of ^bClinical Science, and ^cExperimental Medicine, University of Rome ‘La Sapienza’, Rome, Italy

Article

Publisher ID: 48105 Other ID: Horm Res 2001;56:130–133

DOI: 10.1159/000048105

PubMed ID: 11847476

SO-VID: ded8afba-9bae-437a-a1f8-695154c96377

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A Case of Pheochromocytoma with Renal Artery Stenosis and Post-Surgical Watery Diarrhea

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Most cited references 3

A new human chromogranin 'A' immunoradiometric assay for the diagnosis of neuroendocrine tumours

[123I]Metaiodobenzylguanidine and [111In]Octreotide Uptake in Benign and Malignant Pheochromocytomas

Control of Catecholamine Release and Blood Pressure with Octreotide in a Patient with Pheochromocytoma: A Case Report with in vitro Studies

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