Importance of Ultrasound Imaging in Pheochromocytoma in a Child: Case Report and Review of Literature

Pheochromocytomas are rare tumors, originating from adrenal medulla (80-90%), diagnosed at 0.1% of cases with hypertension. Not very rare (40%), diagnosis can be insidious during ultrasound imaging (US) for a non-specific complaint. We are presenting a 13 years old boy who had suffered from non-specific headache without hypertension and any of autonomic disorders, diagnosed by increased urine catecholamine after a mass seen in US. A 13 years old boy has admitted to emergency with blood pressure measurement of 160/110 mmHg. He had severe headache for 18 months without hypertension. In physical exam, hypertension, tachycardia, tremor, and Marfanoid morphology were found. Ultrasound revealed an incidental mass of 33 ´ 68 mm, with increased vascularization, on pre- and para-aortic sides. Urinary catecholamine and metabolites were grossly elevated. Iodine-131-metaiodobenzylguanidine scintigraphy also showed the heterogeneous mass located in the right para-aortic region, neighboring the liver. Pheochromocytoma is a rare catecholamine-producing tumor, and has life-threatening consequences. Clinical manifestations can be non-specific. It can be easily diagnosed if it is suspected or screened by US. Here we want to emphasize that such an easy and cheap method (screening by US) can lead us to know earlier this high complicated and incidental disease. Int J Clin Pediatr. 2013;2(2):78-82 doi: http://dx.doi.org/10.4021/ijcp122e