1996 Volume 29 Issue 10 Pages 1425-1431
We report a case of pheochromocytoma in a long-term hemodialysis patient. The patient was a 47-year-old man who had been maintained on hemodialysis since November 1977. A right adrenal mass was incidentally discovered on a follow-up CT scan for acquired cystic disease of the kidney (ACDK) in August 1994. He was asymptomatic and endocrine data such as plasma levels of catecholamines (CA), cortisol, aldosterone and ACTH were within normal ranges. He had subsequently been followed periodically, and the tumor tripled in diameter within 17 months. Although MIBG scintigraphy was negative, MRI findings were highly suggestive of pheochromocytoma. A hypertensive attack during the operation was mild and easily controlled by the adminis-tration of low dose nicardipine. As the postoperative plasma CA level was same as that in the preoperative period, the tumor was considered to be endocrinologically inactive. We identified 11 case reports, in the literature, describing long-term hemodialysis complicated by pheochromocytoma. Diagnostic methods and perioperative management are discussed and reviewed herein.
