NECROTIC PHAEOCHROMOCYTOMA WITH GASTRIC HAEMORRHAGE, SHOCK, AND UNCOMMONLY HIGH CATECHOLAMINE EXCRETION

. A 43-year-old man who was admitted to hospital for gastric haemorrhage had a necrotic phaeochromocytoma. The blood loss was corrected, but the patient died in irreversible shock 4 days after admission. There was adrenergic myocardiopathy. The catecholamine excretion was 19,200 μg/24 h, vanilmandelic acid excretion 398 mg/24 h. Values of this magnitude have not been found elsewhere. The autopsy showed necrotic phaeochromocytoma, atrophic gastritis with mucosal necrosis, and myocardiopathy. It is suggested that the tumour necrosis took place as a result of malignant growth within a firm capsule. Very high catecholamine excretion values may indicate the need for emergency surgery in phaeochromocytoma.