World Journal of Endocrine Surgery

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VOLUME 14 , ISSUE 1 ( January-April, 2022 ) > List of Articles


Double Trouble: A Case of a Composite Pheochromocytoma

Imtiaz A Bahemia, Teressa S Thomas, Nasrin Goolam Mahyoodeen, Brooke Puttergill

Keywords : Composite, Diarrhea, Ganglioneuroma, Hypokalemia, Pheochromocytoma

Citation Information : Bahemia IA, Thomas TS, Mahyoodeen NG, Puttergill B. Double Trouble: A Case of a Composite Pheochromocytoma. World J Endoc Surg 2022; 14 (1):27-30.

DOI: 10.5005/jp-journals-10002-1422

License: CC BY-NC 4.0

Published Online: 16-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: Pheochromocytomas are rare neuroendocrine tumors that arise from the chromaffin cells of sympathetic or parasympathetic tissue. Composite pheochromocytomas have additional histological components and account for only 3% of pheochromocytomas. We present a case of composite pheochromocytoma with chronic diarrhea, profound hypokalemia, and global weakness on presentation. Case description: The patient reported an 18-month history of severe vomiting and watery diarrhea, with no associated headaches or sweating. She had an initial serum potassium of 1.1mmol/L (3.5–5.3), requiring a continuous intravenous potassium infusion, intubation, and ventilation for profound weakness. She remained normotensive throughout. A computed tomography (CT) scan revealed a left adrenal mass. She had markedly elevated urine metanephrine and normetanephrine levels [19,823 nmol/24 hr (152–913) and 17,933 nmol/24 hr (262–2129), respectively]. The patient underwent a left adrenalectomy and had complete resolution of her symptoms postoperatively. Histology revealed a composite tumor comprising both pheochromocytoma and ganglioneuroma. Conclusion: This case highlights a rare presentation of pheochromocytoma, being an unusual cause of hypokalemia as well as interesting histopathology.

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