Emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paraganglioma
Pheochromocytoma/paraganglioma (PPGL)-related hypercatecholaminemic crisis is a rare lethal condition caused by uncontrolled catecholamine secretion, occasionally leading to critical fluctuation in blood pressure (BP). Emergent transcatheter arterial embolization (TAE) has been employed for spontane...
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doaj-fe3566a90128492497325bc518ec084f2021-06-29T04:12:17ZengElsevierRadiology Case Reports1930-04332021-08-0116820652071Emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paragangliomaToshiya Kariyasu0Haruhiko Machida1Yoshio Nishina2Mitsuhiro Tambo3Shogo Miyagawa4Takayuki Rakue5Yoshikazu Sumitani6Kazuki Yasuda7Junji Shibahara8Kenichi Yokoyama9Department of Radiology, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanDepartment of Radiology, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, Japan; Corresponding author.Department of Diabetes, Endocrinology and Metabolism, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanDepartment of Urology, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanDepartment of Urology, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanDepartment of Diabetes, Endocrinology and Metabolism, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanDepartment of Diabetes, Endocrinology and Metabolism, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanDepartment of Diabetes, Endocrinology and Metabolism, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanDepartment of Pathology, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanDepartment of Radiology, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, 181-8611, JapanPheochromocytoma/paraganglioma (PPGL)-related hypercatecholaminemic crisis is a rare lethal condition caused by uncontrolled catecholamine secretion, occasionally leading to critical fluctuation in blood pressure (BP). Emergent transcatheter arterial embolization (TAE) has been employed for spontaneous PPGL rupture, but never, to our knowledge, for critical fluctuation in BP associated with PPGL-related hypercatecholaminemic crisis. We describe here our experience utilizing this method to control critical fluctuation in BP associated with this crisis in a 44-year-old man with an unruptured retroperitoneal paraganglioma. The patient experienced sudden severe left abdominal pain and came to our emergency department, where he exhibited severe fluctuation in BP and underwent laboratory testing that showed hypercatecholaminuria and computed tomography (CT) that revealed a left retroperitoneal tumor with no apparent intra- or retroperitoneal hematoma. We performed emergent TAE from the left inferior phrenic artery using gelatin sponge, which stabilized his BP and relieved his abdominal pain. Histologic examination following elective surgical resection of the tumor confirmed our diagnosis of unruptured retroperitoneal paraganglioma. We believe that TAE represents an important option for the emergent treatment of the critical BP fluctuation associated with PPGL-related hypercatecholaminemic crisis.http://www.sciencedirect.com/science/article/pii/S1930043321003125Critical blood pressure fluctuationEmergent transcatheter arterial embolizationHypercatecholaminemic crisisRetroperitoneal paraganglioma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Toshiya Kariyasu Haruhiko Machida Yoshio Nishina Mitsuhiro Tambo Shogo Miyagawa Takayuki Rakue Yoshikazu Sumitani Kazuki Yasuda Junji Shibahara Kenichi Yokoyama |
spellingShingle |
Toshiya Kariyasu Haruhiko Machida Yoshio Nishina Mitsuhiro Tambo Shogo Miyagawa Takayuki Rakue Yoshikazu Sumitani Kazuki Yasuda Junji Shibahara Kenichi Yokoyama Emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paraganglioma Radiology Case Reports Critical blood pressure fluctuation Emergent transcatheter arterial embolization Hypercatecholaminemic crisis Retroperitoneal paraganglioma |
author_facet |
Toshiya Kariyasu Haruhiko Machida Yoshio Nishina Mitsuhiro Tambo Shogo Miyagawa Takayuki Rakue Yoshikazu Sumitani Kazuki Yasuda Junji Shibahara Kenichi Yokoyama |
author_sort |
Toshiya Kariyasu |
title |
Emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paraganglioma |
title_short |
Emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paraganglioma |
title_full |
Emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paraganglioma |
title_fullStr |
Emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paraganglioma |
title_full_unstemmed |
Emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paraganglioma |
title_sort |
emergent transcatheter arterial embolization to control critical blood pressure fluctuation associated with hypercatecholaminemic crisis in a patient with an unruptured retroperitoneal paraganglioma |
publisher |
Elsevier |
series |
Radiology Case Reports |
issn |
1930-0433 |
publishDate |
2021-08-01 |
description |
Pheochromocytoma/paraganglioma (PPGL)-related hypercatecholaminemic crisis is a rare lethal condition caused by uncontrolled catecholamine secretion, occasionally leading to critical fluctuation in blood pressure (BP). Emergent transcatheter arterial embolization (TAE) has been employed for spontaneous PPGL rupture, but never, to our knowledge, for critical fluctuation in BP associated with PPGL-related hypercatecholaminemic crisis. We describe here our experience utilizing this method to control critical fluctuation in BP associated with this crisis in a 44-year-old man with an unruptured retroperitoneal paraganglioma. The patient experienced sudden severe left abdominal pain and came to our emergency department, where he exhibited severe fluctuation in BP and underwent laboratory testing that showed hypercatecholaminuria and computed tomography (CT) that revealed a left retroperitoneal tumor with no apparent intra- or retroperitoneal hematoma. We performed emergent TAE from the left inferior phrenic artery using gelatin sponge, which stabilized his BP and relieved his abdominal pain. Histologic examination following elective surgical resection of the tumor confirmed our diagnosis of unruptured retroperitoneal paraganglioma. We believe that TAE represents an important option for the emergent treatment of the critical BP fluctuation associated with PPGL-related hypercatecholaminemic crisis. |
topic |
Critical blood pressure fluctuation Emergent transcatheter arterial embolization Hypercatecholaminemic crisis Retroperitoneal paraganglioma |
url |
http://www.sciencedirect.com/science/article/pii/S1930043321003125 |
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