Phaeochrornocytorna - a case report

A 52-year-old man presented with a 4-year history of paroxysmal attacks of anxiety, giddiness, palpitation, sweating, and severe headache. These symptoms wereassociated with sudden increases in his blood pressure; and a provisional diagnosis of phaeochromocytoma was made.Collections of urine were submitted for catecholamine assay. One collection showed a slight increase in catecholamines but the rest were normal, including a collection made after a provocation test, using histamine 0,025 mg intravenously. The histamine test did, however, cause systolic and diastolic blood pressure to rise by 20 mmHg.As he was mildly hypertensive between paroxysms, a phentolamine test was carried out, utilising 5 mg well diluted, intravenously, over 5 minutes under basal conditions. This, too, was negative. An aortogram failed to demonstrate convincingly tumour vascularisation, but there was a mild hypertensive crisis during this examination.At laparotomy, a single phaeochromocytoma was found in the right adrenal gland, and was successfully removed. Recovery was uneventful and the patient was discharged, normotensive and not requiring hypotensive therapy, though mild hypertension has developed since. No residual catecholamine activity has been detected.The preparation of the patient for surgery and the control of operative complications are described, and the salient diagnostic features of phaeochromocytoma are briefly discussed.S. Afr. Med. J. 48, 401 (1974)