DOI: https://dx.doi.org/10.18203/2349-2902.isj20221725
Published: 2022-06-27

Atypical presentation of adrenal pheochromocytoma with central tumour necrosis in a paediatric patient: a case report

Aminnur H. Maliki, Nurazim Sidi, Sharifah A. Wan Ali, Adibah Ali

Abstract


Pheochromocytoma is a rare catecholamine producing neuroendocrine tumour in children. It is usually presented with a triad of palpitation, headache, and diaphoresis. It is one of the causes of secondary hypertension in children. We report a case of a girl who presented with atypical symptoms of pheochromocytoma. A 10-year-old girl who presented with chest discomfort, shortness of breath and labile blood pressure. A young hypertension workup revealed a non-functioning left adrenal mass, making the dilemma in the initial clinical diagnosis. Confirmative diagnosis of pheochromocytoma was obtained via histopathological examination of the specimen through laparoscopic left adrenalectomy, which offered both diagnostic and therapeutic values. She was successfully treated via minimally access surgery. Diagnosing a pheochromocytoma in paediatric age group can be challenging due to its scarcity and possible atypical initial presentation. It requires high index of suspicion for a timely diagnosis and prompt treatment.


Keywords


Adrenal, Pheochromocytoma, Large necrosis, Paediatric

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References


Virgone C. Pheochromocytomas and paragangliomas in children: data from the Italian cooperative study (TREP). Pediatr Blood Cancer. 2020;4:e28332.

Pamporaki C. Characteristics of pediatric vs. adult pheochromocytomas and paragangliomas. J Clin Endocrinol Metab. 2017;102(4):1122-32.

Ohara N. Histopathological analysis of spontaneous large necrosis of adrenal pheochromocytoma manifested as acute attacks of alternating hypertension and hypotension: a case report. J Med Case Rep. 2016; 10(1):279.

Fascetti-Leon F. Minimally invasive resection of adrenal masses in infants and children: results of a European multi-center survey. Surg Endoscop. 2017; 31(11):4505-12.

Dokumcu Z. Laparoscopic adrenalectomy in children: A 25-case series and review of the literature. J Pediatr Surg. 2018;53(9):1800-5.