German Treyger, Shawn A. Silver, Alla A. Sakharova. Pheochromocytoma Diagnosis After an Abnormal Stress Test: Case Report and Review of the Literature. J Am Osteopath Assoc 2015;115(7):e3–e7. doi: 10.7556/jaoa.2015.092.
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Pheochromocytoma is a rare adrenal gland tumor that is often difficult for physicians to diagnose because of its general, nonspecific complaints. Diagnosis is particularly difficult in patients with neurofibromatosis 1, because pheochromocytoma in these patients will mimic other cardiovascular abnormalities. The authors report the case of a 60-year-old woman with an extensive history of hyperlipidemia, malignant hypertension, coronary artery disease, and neurofibromatosis 1 who was referred for an elective cardiac catheterization as a result of an abnormal stress test. The patient returned to the hospital 3 days after the procedure complaining of increased angina and palpitations. While hospitalized, she developed severe episodic hypertension. A computed tomographic scan revealed bilateral adrenal masses. Findings of biochemical and imaging evaluation confirmed the diagnosis of bilateral pheochromocytoma. Early screening of pheochromocytomas in high-risk populations is essential for prompt diagnosis and successful management.
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