Article information
Se reporta el caso de una paciente con hipertensión paroxística asociada a síntomas adrenérgicos, en quien se encontraron niveles elevados de metanefrinas totales en orina de 24 horas, hipopotasemia persistente y nódulo en la glándula suprarrenal. Fue llevada a cirugía en la que se identificaron dos masas suprarrenales, una con características histológicas de feocromocitoma y otra de adenoma suprarrenal.
Palabras clave:
hipertensión arterial sistémica
hipertensión refractaría
tumores
We report the case of a female patient with paroxysmal hypertension associated with adrenergic symptoms. Elevated levels of total metanephrines in 24 hour urine were found, as well as persistent hypokalemia and a nodule in the adrenal gland. She was taken to surgery, and two adrenal masses were identified, one with histological characteristics of pheochromocytoma and another one of adrenal adenoma.
Key words:
sistemic arterial hypertension
refractory hypertension
tumors
Full text is only aviable in PDF
Bibliografía
[2.]
A. Grossman, K. Pacak, A. Sawka, J.W.M. Lenders, D. Harlander, R. Peaston, et al.
Biochemical diagnosis and localization of pheochromocytoma ¿Can we reach a consensus?.
Ann N. Y. AcadSci, 1073 (2006), pp. 332-346
[3.]
C.G. Perry, A.M. Sawka, R. Singh, et al.
The diagnostic efficacy of urinary fractionated metanephrines measured by tandem mass spectrometry in detection of pheochromocytoma.
Clin Endocrinol (Oxf), 66 (2007), pp. 703
[4.]
A. Karagiannis, D.P. Mikhailidis, V.G. Athyros, F. Harsoulis.
Pheochromocytoma: an update on genetics and management.
Endocr Relat Cancer, 14 (2007), pp. 935-956
[5.]
T. Ogihara, K. Kikuchi, H. Matsuoka, T. Fujita, J. Higaki, M. Horiuchi, on behalf of the Japanese Society Of Hypertension Committee for guidelines for the management of hypertension, et al.
The JapaneseSociety of Hypertension (JSH 2009).
Hypertens Res, 32 (2009), pp. 4-107
[6.]
J.W. Funder, R.M. Carey, C. Fardella, et al.
Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline.
J Clin Endocrinol Metab, 93 (2008), pp. 3266
[7.]
J.A. Wieneke, L.D.R. Thompson, C.S. Heffess.
Cortico medullary mixed tumor of the adrenal gland.
Ann Diagn Pathol, 5 (2001), pp. 304-308
[8.]
H. Akai, K. Sanoyama, K. Namai, Y. Miura, O. Murakami, K. Hanew, et al.
A case of adrenal mixed tumor of pheochromocytoma and adrenocortical adenoma presenting diabetes mellitus and hypertension.
Nippon Naibunpi Gakkai Zasshi, 69 (1993), pp. 659-669
[9.]
J. Inoue, S. Oishi, S. Naomi, T. Umeda, T. Sato.
Pheochromocytoma associated with adrenocortical adenoma case report and literature review.
Endocrinol Jpn, 33 (1986), pp. 67-74
[10.]
W.Y. Ma, A.H. Yang, Y.H. Chang, L.Y. Lin, H.D. Lin.
Coexistence of adrenal Cushing syndrome and pheochromocytoma in a cortico medullary adenoma.
The Endocrinologist, 17 (2007), pp. 341-345
[11.]
A.Y. Chu, V.A. Livolsi, D.L. Fraker, P.J. Zhang.
Cortico medullary mixed tumor of the adrenal gland with concurrent adrenal myelolipoma.
Arch Pathol Lab Med, 127 (2003), pp. e329-e332
[12.]
A. Wolf, H.D.S. Willenberg, K. Cupisti, M. Schott, H. Geddert, A. Raffel, et al.
Adrenal pheochromocytoma with contralateral cortisol-producing adrenal adenoma: Diagnostic and therapeutic management.
Horm Metab Res, 37 (2005), pp. 391-395
[13.]
D. Cotesta, L. Petramala, V. Serra, S. Giustini, L. Divona, S. Calvieri, et al.
Pheochromocytoma associated with adrenocortical tumor in the same glan.
Minerva Endocrinol, 31 (2006), pp. 183-189
[14.]
H. Sato, H. Igarashi, Y. Kishimoto, K. Yamaguchi, T. Saito, H. Ishida, et al.
Combined tumor consisting of non functioning adrenocortical adenoma and pheochromocytoma in the same gland.
Int J Urol, 9 (2002), pp. 398-401
[15.]
I. Monjero-Ares, C. Gegundez-Gómez, J.M. Couselo-Villanueva, M. Moreda-Pérez, M. Jorge-Iglesias, I. Torres-García, et al.
Asociación de feocromocitoma con adenoma suprarrenal contralateral no funcionante.
Cir Esp, 79 (2006), pp. 126-128
[16.]
M. Wajiki, A. Ogawa, J. Fukui, T. Yamada, Y. Maruyama.
Coexistence of aldosteronoma and pheochromocytoma in an adrenal gland.
J Surg Oncol, 28 (1985), pp. 75-78
[17.]
R.D. Gordon, A.W. Bachmann, S.A. Klemm, T.J. Tunny, M. Stowasser, W.J. Storie, et al.
An association of primary aldosteronism and adrenaline-secreting phaeochromocytoma.
Clin Exp Pharmacol Physiol, 21 (1994), pp. 219-222
[18.]
G.E. Wilkins, N. Schmidt, L. Lee-Son.
Coexistence of pheochromocytoma, adrenal adenoma and hypokalemia.
Can Med Assoc J, 116 (1977), pp. 360-362
[19.]
B.S. Hsieh, F.W. Chen, H.C. Hsu, C.C. Chang, W.Y. Chen.
Hyperaldosteronism with coexistence of adrenal cortical adenoma and pheochromocytoma.
TaiwanYi Xue Hui Za Zhi, 78 (1979), pp. 451-455
[20.]
N. Sakamoto, K. Tojo, T. Saito, K. Fujimoto, T. Isaka, N. Tajima, et al.
Coexistence of aldosterone producing adrenocortical adenoma and pheochromocytoma in an ipsilateral adrenal gland.
Endocr J, 56 (2009), pp. 213-219
[21.]
W.R. Hwang, W.Y. Ma, A.L. Tso, C.C. Pan, Y.H. Chang, H.D. Lin.
Pheocohomocytoma and adrenocortical adenoma in the same gland.
J Chin Med Assoc, 70 (2007), pp. 289-329
[22.]
Y. Ohta, S. Sakata, E. Miyata, A. Iguchi, S. Momosaki, T. Tsuchihashi.
Case report: coexistence of pheochromocytoma and bilateral aldosterone-producing adenomas in a 36 year old woman.
J Hum Hypertens, 24 (2010), pp. 555-557
Copyright © 2012. Sociedad Colombiana de Cardiología y Cirugía Cardiovascular