engleski

MULTIPLE PERIPHERAL EMBOLISMS AND SECONDARY DIABETES MELLITUS IN A PATIENT WITH PHEOCHROMOCYTOMA

A 56-year-old man was admitted to surgical department for bilateral thromboembolisms of the femoral and popliteal arteries. A year before, he had chest pains and two months before he suffered temporary episodes of occipital headache. Paroxysmal jumps of blood pressure with profuse sweating were observed, and pheochromocytoma was suspected. The patient also had elevated values of blood glucose, with no history of diabetes mellitus. High values of catecholamines and vanilmandelic acid were found in 24-hour urine. Computed tomography revealed a tumor of the right adrenal gland. After preoperative treatment with alpha and beta blockers, the tumor was removed. Pathohistologically, it was a benign tumor. The levels of blood pressure and blood glucose normalized after the surgery. While diabetes is not uncommonly associated with pheochromocytoma, there are no published reports on peripheral embolisms in patients with pheochromocytoma. The etiology and pathophysiologic mechanisms of embolisms in our patient remained unknown. Transthoracic echosonography and aortography did not reveal thrombotic masses. Transesophageal echosonography was not performed ; therefore, a thrombus in the left atrium auricle could not be excluded with certainty as a possible cause of embolisms.

pheochromocytoma; peripheral embolisms; diabetes mellitus

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