IMAGES IN EMERGENCY MEDICINE
Headache as a sign of phaeochromocytoma
Department of Critical Care and Anaesthesia, Norfolk and Norwich University Hospital, Norwich, UK
Correspondence to:
Dr K Sanyal, Department of Critical Care and Anaesthesia, Norfolk and Norwich University Hospital, Norwich, UK; ksanyal01@doctors.org.uk
Accepted 3 March 2008
| The first 150 words of the full text of this article appear below. |
Phaeochromocytoma may present as just headache. This is a rare presentation.
A 45-year-old man presented with a 6-month history of sudden onset, short duration (<1 month), focal, excruciating headache associated with pulsating sensation in his abdomen and chest. The frequency varied from 2–3 days to one every 3 weeks. There was no facial flushing or sweating. Examination revealed hypertension (160/95 mm Hg) and a beta-blocker was started without relief. He was referred to a neurologist with a provisional diagnosis of cluster headache. All neurological examinations were normal. Urine catecholamine revealed adrenaline 218 nmol/24 h (normal 0–144) and urinary noradrenalin 3354 nmol/24 h (normal 100–560). Computed tomography scan confirmed a right adrenal pheochromocytoma (fig 1), which was successfully removed laparoscopically after stabilisation.
Figure 1 CT scan showing right adrenal phaeochromocytoma.
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Phaeochromocytoma is a rare catecholamine-producing tumour, usually of adrenal origin. Presentation is variable, with a myriad of possible signs and symptoms
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