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Ultrasound demonstration of a pheochromocytoma of the bladder

✍ Scribed by A. Goodman; J. K. Lipinski

Publisher: John Wiley and Sons
Year: 1984
Tongue: English
Weight: 185 KB
Volume: 12
Category: Article
ISSN: 0091-2751
DOI: 10.1002/jcu.1870120810

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✦ Synopsis

CASE HISTORY

A 19-year-old black female with paroxysmal headaches, palpitations and sweating without an obvious precipitating cause was admitted to our hospital for evaluation. The BP was 290/180 and there was bilateral papiloedema. Her past history included a pregnancy at age 15 when she was treated for pre-eclamptic toxemia. She delivered a normal infant but was lost to follow-up. There were no hematuria or symptoms of catechalomine excess on micturition. The clinical suspicion of a phaeochromocytoma was confirmed biochemically with markedly elevated urinary vanillyl mandelic acid, total metanephrines and total catecholamines. Preoperative localization included CAT scanning of the abdomen and thorax and abdominal angiography. These initial investigations failed to demonstrate a tumor but subsequent selective venous sampling localized high Norepinephrine concentrations from the area drained by the left common iliac vein. The ultrasound demonstrated a 4.6 x 4.4 cm mass in the dome of the bladder [Fig. )]. The CAT scan confirmed this localization.

At laparotomy a 5-cm benign pheochromocytoma was found arising from the dome of the bladder and was removed by partial cystectomy. Postoperatively the patient became normotensive and continues well.

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