CLINICAL CASE
Management and treatment of a patient with a hormonally active adrenal tumor
1 Yaroslavl State Medical University, Yaroslavl, Russia
2 Private Healthcare Institution ‘Russian Railways Clinical Hospital’, Moscow, Russia
Correspondence should be addressed: Anna N. Zhilina
ul. Revolutsionnaya, 5, Yaroslavl, 150000, Russia; ur.liam@9791-anilihz
Author contribution: Zhilina AN — patient management until the surgery, writing the article, summing up data of laboratory and instrumental diagnostics during the preoperative and postoperative stages; Melnikova JuE — MRI diagnostics with pheochromocytoma contrasting; Voronina EA — deciphering genetic research; Martyshova AV — literature review of modern data and recommendations regarding management of patients with this pathology.
In spite of all existing achievements, modern endocrinology comes across a rather complex issue such as treatment of patients with catecholamine secreting tumors. True prevalence of pheochromocytoma is not known, as data obtained during the research depend on criteria of patients’ selection and can vary significantly. The tumors have numerous pathophysiological mechanisms of disease development due to a wide variability of symptoms and complex diagnostics. Meanwhile, timely diagnosis produces a direct effect on prognosis and quality of life. Catecholamine secreting tumors are commonly not detected. In such cases, there is a high risk of severe cardiovascular complications up to a lethal outcome. Complex diagnostics of this pathology also means that the tumors can have adrenal and extraadrenal localization and that the disease is hereditary. This makes diagnostics and treatment of pheochromocytoma even more complex. Timely detection of concomitant tumor and hormonal manifestations belongs to an important factor of management of patients with genetically determined pheochromocytomas. Thus, examination of pheochromocytoma is a pressing issue of modern endocrinology.
Keywords: arterial hypertension, pheochromocytoma, metanephrines and normetanephrines