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Case Report
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| Incidentally discovered intrathoracic extra-adrenal pheochromocytoma during preoperative screening | ||||||
| Merces Assumpcao-Morales1, Vinuta Mohan2, Tasneem Zahra3 | ||||||
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1MD, Department of Internal Medicine, PGY2, Lincoln Medical and Mental Health Center, Bronx, New York, USA.
2MD, FACE, Department of Endocrinology, Lincoln Medical and Mental Health Center, Bronx, New York, USA. 3MD, FACP, FACE, Chief of the Department of Endocrinology, Lincoln Medical and Mental Health Center, Bronx, New York, USA. | ||||||
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| How to cite this article |
| Assumpcao-Morales M, Mohan V, Zahra T. Incidentally discovered intrathoracic extra-adrenal pheochromocytoma during preoperative screening. International Journal of Case Reports and Images 2013;4(11):627–630. |
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Abstract
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Introduction:
We are reporting a case of an incidental mass later diagnosed as an extradural pheochromocytoma at T2-T4 level during a presurgical work up for a gynecological procedure. Only a few cases of extradural paravertebral tumors are described in literature.
Case Report: This is a clinical case of an asymptomatic 26-year-old female with an incidental finding of thoracic mass in chest X-ray during preoperative screening for myomectomy. Work up for this mass showed elevated plasma and urinary metanephrine levels which was consistent to pheochromocytoma. Computed tomography, magnetic resonance imaging and metaiodobenzylguanidine scans demonstrate a mass originating from thoracic spine with cord compression, no adrenal mass, multifocal disease or metastasis. Prior to surgery, the patient was treated with phenoxybenzamine and metoprolol to decrease hemodynamic instability during surgical procedure and also embolization to the arteries supplying the mass to decrease intraoperative bleeding. Patient remained stable during and after the removal of the mass. Pathology report confirmed presence of a 6-cm extradural pheochromocytoma at the T2-T4 location. Conclusion: A high index of suspicion for pheochromocytoma was crucial for the diagnosis in this patient. It is well known that the induction of anesthesia, use of certain drugs and manipulation of the tumor can lead to increase of catecholamine release with serious hemodynamics abnormalities and increase rate of mortality, complications that can be decreased with proper medical management. We report a very rare location of a pheochromocytoma. A high index of suspicion was crucial for the diagnosis and proper treatment in this asymptomatic patient. | |
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Keywords:
Pheochromocytoma, Extra-adrenal, Paravertebral tumor
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Author Contributions
Merces Assumpcao-Morales – Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published Vinuta Mohan – Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Tasneem Zahra – Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Merces Assumpcao-Morales et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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