ࡱ> 463}  bjbjξ 4"ܤfܤf \\\\\pppp, pVR  $^!F-\\\999\\9999 eL9&0V9!!99!\M\9V!X ": Pheochromocytoma: a case report Romana Maruai 1, Tajana Turk 1,2, Dunja Degme i1,3 , Tatjana Ba un1,4 1  Faculty of Medicine Osijek, University of J. J. Strossmayer, Osijek, Croatia 2  Clinical Hospital Centre, Department of Radiology, Osijek, Croatia 3 Clinical Hospital Centre, Department of Psychiatry, Osijek, Croatia 4 Clinical Hospital Centre, Department of Internal Medicine, Osijek, Croatia Introduction:Pheochromocytoma is a tumor arising from chromaffin cells of the adrenal gland medulla and sympathetic ganglia that releases catecholamines. Case report: The clinical photograph shows a 62-year-old patient having arterial hypertension, type 2 diabetes, and hypercholesterolemia, who had a reduced appetite for three months, lost 10 kg, suffered from pain in the lumbosacral spine and felt depressed. The abdominal ultrasound showed an inhomogeneous tumor mass on the right adrenal gland, 5cm x 4.5 cm in size, with minor cystic spaces in the middle. The computed tomography (CT) scan of the abdomen showed a sharply defined heterogenous mass on the right adrenal gland of 4.2x5 cm in diameter with higher absorption coefficients on the edge and lower in the middle (central necrosis), measuring a density of 26 Hounsfield units (HU), on native non-homogeneous post-contrast opacification sections, showing a slow flush of the contrast on post-contrast sections (a relative wash out amounting to 9%, and the absolute one accounting for 20%) a pheochromocytoma is clinically suspected. Medical records indicate that during the previous four years the patient occasionally suffered from palpitation and supraventricular tachycardia with blood pressure levels up to 190/100mmHg. The laboratory analysis showed elevated plasma levels of metanephrine and normetanephrine (12 and 9 times), confirming the diagnosis. A pre-opeartive preparation was performed using alpha-adrenergic receptor blockers (phenoxybenzamine), followed by beta blockers (bisoprolol). Following the surgery, the histopathological examination confirmed the pheochromocytoma diagnosis. The metanephrine and normetanephrine follow-up results were normal. Annual follow-up checkup is recommended for the next 10 years. Conclusion: In case of a clinically suspected pheochromocytoma or during the adrenal gland i $(>@\`dzymyT79hHdhSLB*CJH*OJQJaJfHph"""q 0hf^B*CJOJQJaJfHph"""q hf^CJOJQJaJ6hHdhHdB*CJOJQJaJfHph"""q 9hHdhHdB*CJH*OJQJaJfHph"""q hMhHdCJOJQJaJh d5CJOJQJ\aJhoR5CJOJQJ\aJhf^5CJOJQJ\aJ"hH#hH#5CJOJQJ\aJ @t  I 3  $a$gd dd*$-DM gd d$a$gd d t z ̳y\<<?h dh d6B*CJOJPJQJ]aJmH nH phsH tH ?h dh d6B*CJOJPJQJ]aJmH nH ph"""sH tH 9h dh dB*CJH*OJQJaJfHph"""q 9h dh dB*CJOJPJQJaJmH nH ph"""sH tH 9hHdhSLB*CJH*OJQJaJfHph"""q 0hf^B*CJOJQJaJfHph"""q 0hSLB*CJOJQJaJfHph"""q 3hSLB*CJH*OJQJaJfHph"""q    , - 8 9 H I s t ߢ߂bE(߂b9h d6B*CJOJPJQJ]aJmH nH ph"""sH tH 9hK6B*CJOJPJQJ]aJmH nH ph"""sH tH ?h dhf^6B*CJOJPJQJ]aJmH nH ph"""sH tH ?hf^hf^6B*CJOJPJQJ]aJmH nH ph"""sH tH ?h dh d6B*CJOJPJQJ]aJmH nH phsH tH 9hf^6B*CJOJPJQJ]aJmH nH ph"""sH tH ?h dh d6B*CJOJPJQJ]aJmH nH ph"""sH tH  2 3 > @ ¨yncWHHHj\{cp/IDg6wZ0s=Dĵw %;r,qlEآyDQ"Q,=c8B,!gxMD&铁M./SAe^QשF½|SˌDإbj|E7C<bʼNpr8fnߧFrI.{1fVԅ$21(t}kJV1/ ÚQL×07#]fVIhcMZ6/Hߏ bW`Gv Ts'BCt!LQ#JxݴyJ] C:= ċ(tRQ;^e1/-/A_Y)^6(p[_&N}njzb\->;nVb*.7p]M|MMM# ud9c47=iV7̪~㦓ødfÕ 5j z'^9J{rJЃ3Ax| FU9…i3Q/B)LʾRPx)04N O'> agYeHj*kblC=hPW!alfpX OAXl:XVZbr Zy4Sw3?WӊhPxzSq]y "   8@0(  B S  ? _Hlk27833014  "'.239:>@CDIQUW_a23@D3537  h23  2=CQYdgg,9H  2=CQYdgg,9H hb@$W);9SLoRf^ dHdj[rKMcSbH#^[Q @( @@@Unknown G.[x Times New Roman5Symbol3. .[x Arial7..{$ CalibriS&Liberation SansArial?DejaVu SansI FreeSansCalibriC.,.{$ Calibri LightA$BCambria Math"hAGAGzqzq!r0 KQP @$!xx) Bacun vele aele Oh+'0l   ( 4 @LT\dBacunNormal vele ele2Microsoft Office Word@F#@@$@$zq ՜.+,0 hp|     TitleNaslov  !"$%&'()*,-./0125Root Entry Fp첸71Table!WordDocument4"SummaryInformation(#DocumentSummaryInformation8+CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q