A Case of Pheochromocytoma Accompanied with Alveolar Hemorrhage and Cardiogenic Pulmonary Edema.

Jeong, Jong Pil; Ban, Hee Jung; Kim, Soo Ock; Son, Jun Gwang; Ju, Jin Yung; Kwon, Yong Soo; Oh, In Jae; Kim, Kyu Sik; Kim, Yu Il; Lim, Sung Chul; Kim, Young Chul

doi:2008.64.3.219

Tuberc Respir Dis > Volume 64(3); 2008 > Article

Case Report

Tuberculosis and Respiratory Diseases 2008;64(3):219-223.
DOI: https://doi.org/10.4046/trd.2008.64.3.219 Published online March 1, 2008.

A Case of Pheochromocytoma Accompanied with Alveolar Hemorrhage and Cardiogenic Pulmonary Edema.

Jong Pil Jeong, Hee Jung Ban, Soo Ock Kim, Jun Gwang Son, Jin Yung Ju, Yong Soo Kwon, In Jae Oh, Kyu Sik Kim, Yu Il Kim, Sung Chul Lim, Young Chul Kim

¹Department of Internal Medicine, Gwangju Christian Hospital, Korea.
²Department of Pulmonary and Critical Care Medicine, Chonnam National University Medical School, Korea. droij@chonnam.ac.kr
³Department of Internal Medicine, Miraero21 Hospital, Gwangju, Korea.
⁴Department of Internal Medicine, Seonam University College of Medicine, Namwon, Korea.

Abstract

Pheochromocytoma is derived from the chromaffin tissue. The typical finding of pheochromocytoma is paroxysmal hypertension accompanied with various signs and symptoms that are due to the excess of catecholamines or other bioactive substances. Yet the diagnosis is sometimes difficult to make because its clinical presentation is quite variable. Especially, hemoptysis is a very rare symptom, so the diagnosis is often missed or delayed. Without making the correct diagnosis and then subsequently administering treatment, the condition may be fatal. We herein report on a 68 year-old woman who was admitted because of abdominal pain and hemoptysis. The initial radiologic findings suggested pulmonary edema with alveolar hemorrhage. The urine catecholamine levels were elevated and she developed catecholamine-induced cardiomyopathy. We performed bronchial arterial embolization and we administered alpha blocker medication for controlling the hemoptysis and hypertension. After the temporary symptomatic improvement, her clinical course was aggravated by pneumonia and pulmonary edema. In spite of performing definitive surgery for pheochromocytoma, she died of postoperative hemodynamic instability.

Key Words: Pheochromocytoma, Alveolar hemorrhage, Cardiogenic pulmonary edema