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Unexplained Cachexia as a Presenting Symptom of Pheochromocytoma in a Geriatric Patient

Pheochromocytomas are rare neuroendocrine tumors that may secrete catecholamines, resulting in a wide array of clinical symptoms. While patients classically present with hypertension, headache, diaphoresis, and flushing, these symptoms are present in only 40% of cases. Here, we describe a 70-year-ol...

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Autores principales: Nkodo, Amélie, Wu, Iris, Hobgood, Sarah, Celi, Francesco S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580407/
https://www.ncbi.nlm.nih.gov/pubmed/37908484
http://dx.doi.org/10.1210/jcemcr/luad037
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author Nkodo, Amélie
Wu, Iris
Hobgood, Sarah
Celi, Francesco S
author_facet Nkodo, Amélie
Wu, Iris
Hobgood, Sarah
Celi, Francesco S
author_sort Nkodo, Amélie
collection PubMed
description Pheochromocytomas are rare neuroendocrine tumors that may secrete catecholamines, resulting in a wide array of clinical symptoms. While patients classically present with hypertension, headache, diaphoresis, and flushing, these symptoms are present in only 40% of cases. Here, we describe a 70-year-old woman whose predominant symptom was unexplained severe weight loss over a 12-month period associated with fatigue, anxiety, and palpitations at her endocrinologist and geriatrician visits. Diagnostic imaging was performed to assess for malignancy and demonstrated a 2.0 cm × 2.0 cm left adrenal mass. The diagnosis of pheochromocytoma was confirmed by elevated plasma normetanephrine levels. After a 2-week alpha blockade with doxazosin, the patient underwent robotic left adrenalectomy. Following surgery, the patient regained weight, and her hypertension also improved significantly. We hope this uncommon clinical presentation in an older adult characterized by weight loss and frailty will increase the awareness of atypical pheochromocytoma symptomatology, particularly in older individuals.
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spelling pubmed-105804072023-10-31 Unexplained Cachexia as a Presenting Symptom of Pheochromocytoma in a Geriatric Patient Nkodo, Amélie Wu, Iris Hobgood, Sarah Celi, Francesco S JCEM Case Rep Case Report Pheochromocytomas are rare neuroendocrine tumors that may secrete catecholamines, resulting in a wide array of clinical symptoms. While patients classically present with hypertension, headache, diaphoresis, and flushing, these symptoms are present in only 40% of cases. Here, we describe a 70-year-old woman whose predominant symptom was unexplained severe weight loss over a 12-month period associated with fatigue, anxiety, and palpitations at her endocrinologist and geriatrician visits. Diagnostic imaging was performed to assess for malignancy and demonstrated a 2.0 cm × 2.0 cm left adrenal mass. The diagnosis of pheochromocytoma was confirmed by elevated plasma normetanephrine levels. After a 2-week alpha blockade with doxazosin, the patient underwent robotic left adrenalectomy. Following surgery, the patient regained weight, and her hypertension also improved significantly. We hope this uncommon clinical presentation in an older adult characterized by weight loss and frailty will increase the awareness of atypical pheochromocytoma symptomatology, particularly in older individuals. Oxford University Press 2023-04-21 /pmc/articles/PMC10580407/ /pubmed/37908484 http://dx.doi.org/10.1210/jcemcr/luad037 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Nkodo, Amélie
Wu, Iris
Hobgood, Sarah
Celi, Francesco S
Unexplained Cachexia as a Presenting Symptom of Pheochromocytoma in a Geriatric Patient
title Unexplained Cachexia as a Presenting Symptom of Pheochromocytoma in a Geriatric Patient
title_full Unexplained Cachexia as a Presenting Symptom of Pheochromocytoma in a Geriatric Patient
title_fullStr Unexplained Cachexia as a Presenting Symptom of Pheochromocytoma in a Geriatric Patient
title_full_unstemmed Unexplained Cachexia as a Presenting Symptom of Pheochromocytoma in a Geriatric Patient
title_short Unexplained Cachexia as a Presenting Symptom of Pheochromocytoma in a Geriatric Patient
title_sort unexplained cachexia as a presenting symptom of pheochromocytoma in a geriatric patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580407/
https://www.ncbi.nlm.nih.gov/pubmed/37908484
http://dx.doi.org/10.1210/jcemcr/luad037
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