石灰化をともなった褐色細胞腫の1例

Abstract

A rare case of calcified pheochromocytoma is reported. A 33-year-old man was hospitalized at the Department of Internal Medicine on February 28, 1981 under the diagnosis of chronic hepatitis. He had often complained of headache, chest pain, cold sweating and left upper abdominal pain for several years. Physical examination revealed no abnormal findings. His blood pressure ranged from 150 to 120 by systolic and from 110 to 70 by diastolic, although there was no evidence of hypertension before his admission. A plain film of the abdomen showed an egg-shell-typed calcification of 51×40 mm on the left upper abdomen. In IVP, no displacement of the left kidney was seen, but the calcified shadow was superimposed on the upper pole of the left kidney. A computerized tomography delineated a tumor with calcification in the left retroperitoneal space. Adrenal scintigram with 131-I Adosterol revealed no uptake by the left adrenal gland. Laboratory studies were within normal ranges except for the elevation of serum COT and CPT. The excretion of catecholamines, metanephrines and vanillyl mandelic acid in the 24-hour urine were elevated. He was referred to the Urological Department. Left adrenalectomy was performed through an anterior abdominal approach on June 3, 1981. The extirpated tumor weighed 140 gm and was histologically confirmed as pheochromocytoma. Convalescence was uneventful. Catecholamine excretion was lowered to within the normal range and his symptoms disappeared postoperatively. The literature was reviewed.