Two Cases of Pheochromocytoma

Abstract

Pheochromocytoma is often accompanied by anxiety symptoms, so we need to differentiate anxiety neurosis from pheochromocytoma. We experienced two cases of pheochromocytoma, one patient complained of anxiety and the other did not. The patient with anxiety was a 40 year old man who consulted our hospital because of palpitations and headache with anticipatory anxiety. Our diagnosis was anxiety neurosis, so we administered lorazepam. It was not effective, but sulpiride improved his condition. As the diagnosis was pheochromocytoma, he was operated on for a tumor. A Y-G Personal Invetory before the operation showed aggressiveness, and after the operation was provisional normal. A Rorschach test revealed passiveness and dependence. The other patient was a 17 year old man who did not complain of anxiety. He entered our hospital (urological department) for a pheochromocytoma operation. We carried out a psychological test with his agreement. A Y-G Personal Inventory showed almost a normal profile. A CMI profile before the operation was provisional neurosis but after the operation was provisional normal. MAS was within a normal limit. The catecholamine concentration of Case 2 was higher than that of Case 1,but anxiety symptoms were not accompanied with Case 2. Peripheral catecholamine is said to be relevent to anxiety. Our cases suggest that high peripheral catecholamine alone cannot evoke anxiety but with other factors, e.g. congnitive factor, can evoke anxiety.