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J Postgrad Med. 2019 Jan-Mar;65(1):44-46. doi: 10.4103/jpgm.JPGM_701_17.

Synchronous renal cell carcinoma and pheochromocytoma presenting as acute decompensated heart failure.

Author information

1
School of Medicine, National Defense Medical Center, Taipei, Taiwan.
2
Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
3
Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
4
Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Abstract

We report a 49-year-old woman who presented with a hypertensive crisis and acute heart failure and reduced left ventricular systolic function. An abdominal ultrasonography revealed a huge lobulated heterogeneous mass at the lower pole of the right kidney and a mass over the left suprarenal area, which were further delineated by magnetic resonance imaging. The patient underwent laparoscopic right radical nephrectomy and left adrenalectomy. Histopathological analysis confirmed the diagnoses of clear cell renal cell carcinoma of the right kidney with metastasis to the lung; and atypical pheochromocytoma of the left adrenal gland. Target therapy was initiated, which resulted in stabilization of the patient's tumors and the recovery of her heart function. To avoid a delayed diagnosis and catastrophic outcome, clinicians should consider such rare causes of acute decompensated heart failure.

KEYWORDS:

Heart failure; hypertensive crisis; pheochromocytoma; renal cell carcinoma

PMID:
30693873
DOI:
10.4103/jpgm.JPGM_701_17
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