PHEOCHROMOCYTOMA OF THE ORGANS OF ZUCKERKANDL DIAGNOSED BY REGIONAL BLOOD SAMPLING AND ABDOMINALCT SCANNING-REPORT OF A CASE WISH THE SMALLEST SOLITARY EXTRA-ADRENALPHEOCHROMOCYTOMA IN JAPAN

Abstract

Based on the high plasma norepinephrine concentration and markedly increased urinary excretion of catecholamines, a possibility of pheochromocytoma was seriously suspected in a 30- year-old man admitted for evaluation of hypertension. Routine examination such as intravenous pyelography, thoracic and abdominal aortography and adrenal CT scanning failed to localize the tumor, but serial venous blood sampling demonstrated a localized significant elevation of plasma norepinephrine concentration in inferior vena cava at the level of the second lumbar vertebra. ACT scanning performed thereafter showed a 2.0x1.8x1.6cm mass in the corresponding region.Finally, an extra-adrenal pheochromocytoma weighing 3.5 g was excised. This is the smallest solitary extra-adrenal pheochromocytoma hitherto reported in Japan as far as we know.