We report an exceptional case of cardiac phaeochromocytoma which raised problems of localization. A 30-year-old man, who for several years had been hypertensive, was admitted for attacks of paroxysmal hypertension. Very high levels of urinary catecholamines suggested a diagnosis of phaeochromocytoma, but no tumour was found at computerized tomography (CT) and metaiodobenzylguanidine (MIBG) scintigraphy. However, regional venous samplings detected 2 para-carotid phaeochromocytomas which were surgically removed. Thereafter, the symptoms persisted and investigations were resumed. As new regional venous samplings showed high levels of catecholamines in the right atrium, a mediastinal and, chiefly, cardiac phaeochromocytoma was suspected. No tumour was visible at CT or ultrasonography and another MIBG scintigraphy proved negative. Coronary angiography showed a very large tumour behind the left atrium, well supplied by the circumflex artery and by a branch of the right coronary artery. The patient was operated upon and is now totally asymptomatic after a 9-month follow-up. This case emphasizes the value of invasive methods (i.e. regional venous sampling and coronary angiography) in the localization of this ectopic tumour. In most cases, however, phaeochromocytomas can be localized by MIBG scintigraphy.
|Translated title of the contribution||Cardiac phaeochromocytoma: Failure of conventional non-invasive diagnostic methods|
|Number of pages||4|
|Journal||Archives des Maladies du Coeur et des Vaisseaux|
|State||Published - 1989|
All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine