COEXISTENCE OF PHEOCHROMOCYTOMA AND HYPERCORTISOLEMIA. DIAGNOSTIC DIFFICULTIES

Pol Merkur Lekarski. 2023;51(4):423-429. doi: 10.36740/Merkur202304118.

Abstract

Objective: Aim: Our study aimed to present diagnostic problems in the case of hypercortisolism, pheochromocytoma, hypertension, type 2 diabetes, and chronic kidney disease.

Patients and methods: Materials and Methods: Description of a patient with resistant hypertension admitted to the Department of Endocrinology for hormonal diagnostics. The results of hormonal tests and imaging tests before the procedure were analyzed, and the patient's condition was checked after the procedure. The analysis was extended with a literature review, considering the diagnostic problems in the described case. Electronic databases were the primary way to search, mainly MEDLINE and PubMed. We described a case of a 61-year-old woman diagnosed with right adrenal pheochromocytoma, hypercortisolemia, chronic kidney disease, drug-resistant hypertension, type 2 diabetes, and hypercholesterolemia. During hospitalization in the Department of Endocrinology, i.a., imaging tests and tests to assess adrenal function were performed. During the diagnostic process, a decision was made to perform surgical treatment of the pheochromocytoma, resulting in clinical improvement of the patient's condition.

Conclusion: Conclusions: The described case presents diagnostic problems endocrinologists face in the coexistence of several diseases. Often, the diagnosis to make a final diagnosis is complicated, hindered by the patient's multi-morbidity, as well as by the medications taken. There are few studies analyzing the coexistence of the diseases as described by us and their impact on the results of diagnostic tests that would facilitate the diagnosis.

Keywords: pheochromocytoma; Cushing’s syndrome; diagnostic difficulties; hypercortisolemia; pseudo-Cushing’s syndrome.