Abstract
We describe a case of multiple cerebral infarction secondary to an extra-adrenal pheochromocytoma preoperatively.
A 48-year-old woman under treatment for diabetes and hypertension which were pointed out at medical checkup had paroxysmal headache in the early hours of the morning. She was admitted to the hospital for the evaluation of secondary hypertension in January, 1994.
On physical examination, an elastic hard mass approximately 5cm in diameter was observed in the right lower abdomen. Laboratory studies showed abnormal elevation of catecholamines, especially noradrenaline, in both serum and urine. CT scan, MRI, 123I-MIBG scintigraphy and angiography revealed the para-aortic solid mass at the level of the fourth lumbar vertebra. Based on these findings, we diagnosed this case as extra-adrenal pheochromocytoma.
But right-sided hemiparesis occurred suddenly on May 13, and head CT scan showed multiple cerebral infarction. After improving in condition, an encapsulated, yellowish, solid tumor was excised through the abdominal approach on April 7. The tumor had no local invasion, lymph node involvement and other abnormal masses.
As of one and half years after the operation, the patient is doing well without recurrence in both clinically and endocrinologically.
