Alertness to Nervous System Damage Caused by Pheochromocytoma ( Misdiagnosis Analysis of 20 Cases)

HAO Ya-nan; WANG Guo-fang; LI Gang; KONG Yan

doi:10.3969/j.issn.1002-3429.2016.03.017

Abstract：Objective To investigate the clinical characteristics of nervous system damage caused by the pheochromo-cytoma in order to reduce misdiagnosis and mistreatment rates. Methods We retrospectively analyzed clinical data of 20 mis-diagnosed cases with pheochromocytoma during January 2005 and January 2015. Results 20 patients had hypertension for a long time and the effect of the conventional antihypertensive medication was poor. The main symptoms were dizziness, head-ache, vomiting, walking instability, lack of power, convulsions, disturbance of consciousness, limb hemiplegia and numb-ness. After visits to neurology department, 9 cases were misdiagnosed as cerebral blood supply insufficiency, 5 cases of epi-lepsy, 2 cases of encephalitis, 1 case of benign intracranial hypertension, 2 cases complicated with acute cerebral infarction, and 1 case with cerebral hemorrhage, all of which respectively underwent ultrasound, CT and MRI examinations and blood cat-echolamine, 24-hour urine vanilla bitter almond acid detection. Histopathological results showed that all the cases were benign pheochromocytoma, adrenal with 19 cases of, and 1 case of bladder. 17 cases of postoperative blood pressure returned to nor-mal, 3 cases of blood pressure was still on the high side to CCB class step-down, and blood pressure was well controlled. Conclusion Neural physicians should be alert to nervous system damage caused by pheochromocytoma. For invalid conven-tional antihypertensive drug treatment, paroxysmal hypertension and nervous system damage, physicians should be more vigi-lant about pheochromocytoma. Urinary tract imaging examination and blood catecholamine, 24-hour urine vanilla base of bitter almond acid test are essential in avoiding misdiagnosis.