Background: Pheochromocytoma (PH) is a rare tumor developed at the expense of the adrenal medulla and secreting catecholamines. It is also a rare cause of curable hypertension in adults. Case information: We reported a case of PH in a 39-year-old Malagasy woman, with no particular history. The clinic was dominated by the onset of paroxysmal hypertension associated with headache, palpitations, and sweating. Its clinical manifestations were revealed by the insertion of an etonogestrel contraceptive implant. Despite the removal of the contraceptive implant and the taking of an antihypertensive drug based on a calcium channel blocker, the hypertension persisted with a paroxysmal character and always associated with the Menard triad. Results: The diagnosis was made against the elevation of urinary metanephrines and normetanephrines and the presence of a heterogeneous left adrenal mass on computed tomography. Surgical resection of the tumor made it possible to perform an immunohistochemical examination confirming the diagnosis. Without surgical complications, the patient's blood pressure as well as urinary metanephrine and normetanephrine, normalized without taking any antihypertensive drug. Conclusion: Hormonal contraception could be wrongly blamed the cause of hypertension. Then she would just be a triggering factor. Thus, any atypical hypertension following the use of a hormonal contraceptive must encourage the search for a secondary cause such as PH.
| Published in | International Journal of Diabetes and Endocrinology (Volume 6, Issue 1) |
| DOI | 10.11648/j.ijde.20210601.12 |
| Page(s) | 5-8 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Contraceptive Implant, Metanephrines, Normetanephrine, Pheochromocytoma
| [1] | Neumann H. Pheochromocytoma. In: Kasper DL, Hauser SL, Jameson JL, Fauci AS, Longo DL, Loscalzo J, editors. Harrison’s principles of internal medicine. 19th Edition. New York: McGraw-Hill; 2015. p. 2329-35. |
| [2] | Lenders JWM, Eisenhofer G. Update on Modern Management of Pheochromocytoma and Paraganglioma. Endocrinol Metab 2017; 32: 152-61. |
| [3] | Neumann H, Young WF, Eng C. Pheochromocytoma and Paraganglioma. N Engl J Med 2019; 381: 552-65. |
| [4] | Cawood TJ, Hunt PJ, O’Shea D, Cole D, Soule S. Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant: time for a rethink? Eur J Endocrinol 2009; 161: 513-27. |
| [5] | Riester A, Weismann D, Quinkler M, Lichtenauer UD, Sommerey S, Halbritter R, et al. Life-threatening events in patients with pheochromocytoma. Eur J Endocrinol 2015; 173: 757-64. |
| [6] | Zelinka T, Petrák O, Turková H, Holaj R, Štrauch B, Kršek M et al. High incidence of cardiovascular complications in pheochromocytoma. Horm Metab Res. 2012; 44: 379-84. |
| [7] | Sánchez-Turcios RA. Pheochromocytomas: diagnosis and treatment. Rev Mex Cardiol 2015; 26 (3): 118-24. |
| [8] | Farrugia FA, Martikos G, Tzanetis P, Charalampopoulos A, Misiakos E, Zavras N et al. Pheochromocytoma, diagnosis and treatment: Review of the literature. Endocrine Regulations 2017; 51 (3): 168-81. |
| [9] | Thompson LDR. Pheochromocytoma. Pathology Case Reviews 2005; 10: 243-51. |
| [10] | Cai Q, Xu Z, Yang N, Shao D, Zhang R, Li H et al. A case of pheochromocytoma presenting with Takotsubo cardiomyopathy as the frst symptom without hypertension. Int J Clin Exp Med 2019; 12 (5): 6447-51. |
| [11] | Alyea RA, Laurence SE, Kim SH, Katzenellenbogen BS, Katzenellenbogen JA, Watson CS. The roles of membrane estrogen receptor subtypes in modulating dopamine transporters in PC-12 cells. J Neurochem. 2008; 106 (4): 1525–1533. |
| [12] | Alyea RA, Watson CS. Differential Regulation of Dopamine Transporter Function and Location by Low Concentrations of Environmental Estrogens and 17β-Estradiol. Environ Health Perspect 2009; 117: 778–783. |
| [13] | Haroon S, Naveed KA. Effect of hormonal contraceptives on serum electrolytes and blood pressure. J Post Med Inst 2014; 28 (4): 409-13. |
| [14] | Ribeiro CCM, Shimo AKK, Lopes MHBM, Lamas JLT. Effects of different hormonal contraceptives in women’s blood pressure values. Rev Bras Enferm [Internet]. 2018; 71 (Suppl 3): 1453-9. |
| [15] | Perry CG, Sawka AM, Singh R, Thabane L, Bajnarek J, Young Jr WF. The diagnostic efficacy of urinary fractionated metanephrines measured by tandem mass spectrometry in detection of pheochromocytoma. Clin Endocrinol (Oxf). 2007; 66: 703–708. |
| [16] | Čtvrtlík F, Koranda P, Schovánek J, Škarda J, Hartmann I, Tüdös Z. Current diagnostic imaging of pheochromocytomas and implications for therapeutic strategy (Review). Exp Ther Med 2018; 15: 3151-60. |
| [17] | Baez JC, Jagannathan JP, Krajewski K, O’Regan K, Zukotynski K, Kulke M et al. Pheochromocytoma and paraganglioma: imaging characteristics. Cancer Imaging 2012; 12: 153-162. |
| [18] | Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, Murad MH, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99: 1915-42. |
| [19] | Johnston PC, Mullan KR, Atkinson AB, Eatock FC, Wallace H, Gray M et al. Recurrence of phaeochromocytoma and abdominal paraganglioma after initial surgical intervention. Ulster Med J 2015; 84 (2): 102-106. |
| [20] | Press D, Akyuz M, Dural C, Aliyev S, Monteiro R, Mino J et al. Predictors of recurrence in pheochromocytoma. Surgery 2014; 156: 1523-8. |
| [21] | Amar L, Fassnacht M, Gimenez-Roqueplo A-P, Januszewicz A, Prejbisz A, Timmers H et al. Long-term Postoperative Follow-up in Patients with Apparently Benign Pheochromocytoma and Paraganglioma. Horm Metab Res 2012; 44: 385–389. |
| [22] | Taïeb D, Hicks RJ, Hindié E, Guillet BA, Avram A, Ghedini P et al. European Association of Nuclear Medicine Practice Guideline/Society of Nuclear Medicine and Molecular Imaging Procedure Standard 2019 for radionuclide imaging of phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging 2019; 46 (10): 2112-2137. |
APA Style
Sitraka Angelo Raharinavalona, Nathan Ratsimarisolo, Rija Eric Raherison, Solofo Andrianarivelo Ralamboson, Hanta Marie Danielle Vololontiana, et al. (2021). A Case of Pheochromocytoma Revealed by an Etonogestrel Contraceptive Implant Use. International Journal of Diabetes and Endocrinology, 6(1), 5-8. https://doi.org/10.11648/j.ijde.20210601.12
ACS Style
Sitraka Angelo Raharinavalona; Nathan Ratsimarisolo; Rija Eric Raherison; Solofo Andrianarivelo Ralamboson; Hanta Marie Danielle Vololontiana, et al. A Case of Pheochromocytoma Revealed by an Etonogestrel Contraceptive Implant Use. Int. J. Diabetes Endocrinol. 2021, 6(1), 5-8. doi: 10.11648/j.ijde.20210601.12
AMA Style
Sitraka Angelo Raharinavalona, Nathan Ratsimarisolo, Rija Eric Raherison, Solofo Andrianarivelo Ralamboson, Hanta Marie Danielle Vololontiana, et al. A Case of Pheochromocytoma Revealed by an Etonogestrel Contraceptive Implant Use. Int J Diabetes Endocrinol. 2021;6(1):5-8. doi: 10.11648/j.ijde.20210601.12
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Download@article{10.11648/j.ijde.20210601.12,
author = {Sitraka Angelo Raharinavalona and Nathan Ratsimarisolo and Rija Eric Raherison and Solofo Andrianarivelo Ralamboson and Hanta Marie Danielle Vololontiana and Andrinirina Dave Patrick Rakotomalala},
title = {A Case of Pheochromocytoma Revealed by an Etonogestrel Contraceptive Implant Use},
journal = {International Journal of Diabetes and Endocrinology},
volume = {6},
number = {1},
pages = {5-8},
doi = {10.11648/j.ijde.20210601.12},
url = {https://doi.org/10.11648/j.ijde.20210601.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20210601.12},
abstract = {Background: Pheochromocytoma (PH) is a rare tumor developed at the expense of the adrenal medulla and secreting catecholamines. It is also a rare cause of curable hypertension in adults. Case information: We reported a case of PH in a 39-year-old Malagasy woman, with no particular history. The clinic was dominated by the onset of paroxysmal hypertension associated with headache, palpitations, and sweating. Its clinical manifestations were revealed by the insertion of an etonogestrel contraceptive implant. Despite the removal of the contraceptive implant and the taking of an antihypertensive drug based on a calcium channel blocker, the hypertension persisted with a paroxysmal character and always associated with the Menard triad. Results: The diagnosis was made against the elevation of urinary metanephrines and normetanephrines and the presence of a heterogeneous left adrenal mass on computed tomography. Surgical resection of the tumor made it possible to perform an immunohistochemical examination confirming the diagnosis. Without surgical complications, the patient's blood pressure as well as urinary metanephrine and normetanephrine, normalized without taking any antihypertensive drug. Conclusion: Hormonal contraception could be wrongly blamed the cause of hypertension. Then she would just be a triggering factor. Thus, any atypical hypertension following the use of a hormonal contraceptive must encourage the search for a secondary cause such as PH.},
year = {2021}
}
TY - JOUR T1 - A Case of Pheochromocytoma Revealed by an Etonogestrel Contraceptive Implant Use AU - Sitraka Angelo Raharinavalona AU - Nathan Ratsimarisolo AU - Rija Eric Raherison AU - Solofo Andrianarivelo Ralamboson AU - Hanta Marie Danielle Vololontiana AU - Andrinirina Dave Patrick Rakotomalala Y1 - 2021/01/12 PY - 2021 N1 - https://doi.org/10.11648/j.ijde.20210601.12 DO - 10.11648/j.ijde.20210601.12 T2 - International Journal of Diabetes and Endocrinology JF - International Journal of Diabetes and Endocrinology JO - International Journal of Diabetes and Endocrinology SP - 5 EP - 8 PB - Science Publishing Group SN - 2640-1371 UR - https://doi.org/10.11648/j.ijde.20210601.12 AB - Background: Pheochromocytoma (PH) is a rare tumor developed at the expense of the adrenal medulla and secreting catecholamines. It is also a rare cause of curable hypertension in adults. Case information: We reported a case of PH in a 39-year-old Malagasy woman, with no particular history. The clinic was dominated by the onset of paroxysmal hypertension associated with headache, palpitations, and sweating. Its clinical manifestations were revealed by the insertion of an etonogestrel contraceptive implant. Despite the removal of the contraceptive implant and the taking of an antihypertensive drug based on a calcium channel blocker, the hypertension persisted with a paroxysmal character and always associated with the Menard triad. Results: The diagnosis was made against the elevation of urinary metanephrines and normetanephrines and the presence of a heterogeneous left adrenal mass on computed tomography. Surgical resection of the tumor made it possible to perform an immunohistochemical examination confirming the diagnosis. Without surgical complications, the patient's blood pressure as well as urinary metanephrine and normetanephrine, normalized without taking any antihypertensive drug. Conclusion: Hormonal contraception could be wrongly blamed the cause of hypertension. Then she would just be a triggering factor. Thus, any atypical hypertension following the use of a hormonal contraceptive must encourage the search for a secondary cause such as PH. VL - 6 IS - 1 ER -
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