A CASE OF PHEOCHROMOCYTOMA: DIAGNOSIS BY THE BENZODIOXANE TEST, URINARY HORMONE STUDIES, AND NOR-EPINEPHRINE ASSAY OF THE TUMOR

Abstract

MORE cases of pheochromocytoma are being seen today because of the current interest in the etiology and pathogenesis of hypertension. Many of these patients present sustained hypertension rather than the classic, paroxysmal type. In a recent review of 51 cases, Green (1) found that 14 subjects showed intermittent and 37 chronic hypertension. With the development of the Benzodioxane test by Goldenberg et al. (2), a method for the screening of hypertensive patients for the presence of this tumor became available.

This communication is concerned with a patient, observed in this hospital for over two years, in whom the disease simulated renal hypertension. The diagnosis of pheochromocytoma was made by means of the Benzodioxane test and was followed by successful removal of the tumor. A pharmacologic study of the tumor was made, which gave evidence of the presence of nor-epinephrine.

CASE REPORT

H.D.M., #37319, a 12-year-old, colored male, was first admitted November 25, 1946, in a semi-comatose state. According to his parents he had been well until four days before admission when he complained of a severe headache and repeated attacks of vomiting. Immediately before admission he had several clonic convulsions. When first examined, he was unconscious, the blood pressure was 180/80, the pulse rate 130; there were no abnormal neurologic findings, no choked discs, and the spinal fluid was normal. The coma became deeper; a pneumoencephalogram taken at this time did not reveal anything abnormal. Following this procedure the patient went into a state of shock. Plasma and whole blood were administered and within a few days he became conscious and rational. On discharge the blood pressure was 160/80.