Sepsis Unfolding a Very Large Pheochromocytoma in an Elderly Patient: A Case Report
DOI:
https://doi.org/10.37506/ijphrd.v11i3.3946Keywords:
Giant pheochromocytoma, asymptomatic, elderly, triggering factor, aggressive tumorAbstract
Pheochromocytoma in elderly, often escapes the diagnosis or diagnosed incidentally. Even large
pheochromocytoma can be non-secreting until triggered by an external factor. We report here, a case of
very large tumor in an elderly patient which was silent till she was hospitalized with sepsis. A 72-years-old
female admitted with fever for 15 days. Physical examination and investigations led to the diagnosis of
lower respiratory infection with sepsis. Ultrasonography followed by CT scan showed left cystic suprarenal
mass of 16.4x13.9x11.7 cm and 24-hour fractionated metanephrines were elevated by >3 fold the upper
normal limit by high performance liquid chromatography (HPLC) method. Histopathology confirmed
pheochromocytoma and biologically aggressive tumor (Pheochromocytoma of the adrenal gland scaled
score of 4). Based on literature search, our case represents one of the largest, biologically aggressive,cystic
pheochromocytoma in elderly.