Phaeochromocytoma and reversible myocardial ischaemia in a 23-year old female

Abstract

Background: Phaeochromocytoma is a rare neuroendocrine tumour with highly variable clinical presentation including serious and potentially lethal cardiovascular complications.
Aim: To present a case of myocardial ischaemia in Phaeochromocytoma which was reversed after surgery.
Setting: University of Port Harcourt Teaching Hospital (UPTH).
Case report: A young female undergraduate aged 23 years presented with recurrent blackouts, paroxysmal hypertension which was resistant to several anti- hypertensive drugs and marked postural drop was referred from a private clinic to UPTH. Rest electrocardiogram (ECG) showed ischaemic changes and right axis deviation. Ultrasound scan and computerised tomographic (CT) scan showed a mass on the anteromedial portion of the left kidney with centrally located cystic areas. The 24-hour urine level of vanillyl mandelic acid (VMA) was normal. The tumour was excised by open surgery and histopathological findings confirmed Phaeochromocytoma. The ECG changes reversed after surgical excision. There was no recurrence or metastasis postoperatively after a long term follow up of 5 years. Her blood pressure remained normal postoperatively without taking antihypertensive medication.
Conclusion: Phaeochromocytoma is a catecholamine secreting neuroendocrine tumour with a high cardiovascular morbidity and mortality. ECG features of myocardial ischaemia can be reversed by surgical intervention.


Keywords: Phaeochromocytoma, Reversible myocardial ischaemia, Surgical intervention

Port Harcourt Medical Journal Vol. 2 (3) 2008: pp. 263-267