Thunderclap-like headache triggered by micturition and angina as an initial manifestation of bladder pheochromocytoma. A case report

Sao Paulo Med J. 2015 Mar-Apr;133(2):154-9. doi: 10.1590/1516-3180.2013.6890002. Epub 2014 Nov 28.

Abstract

Context: Pheochromocytoma is a catecholamine-producing tumor characterized by hypertension, headache, tachycardia, excessive diaphoresis and angina. The thunderclap headache is so named because the pain strikes suddenly and severely. Although the symptoms of bladder pheochromocytoma are rather evident, the diagnosis of this rare neuroendocrine tumor can be missed.

Case report: This study reports the case of a woman diagnosed with bladder pheochromocytoma who experienced thunderclap headache triggered by micturition and angina as an initial manifestation.

Conclusion: This case study suggests that thunderclap headache and angina occurring concurrently with sudden blood pressure elevation during or immediately after micturition are important diagnostic clues for bladder pheochromocytoma.

CONTEXTO:: Feocromocitoma é um tumor produtor de catecolaminas, caracterizado por hipertensão, cefaleia, taquicardia, sudorese excessiva e angina. A dor de cabeça trovão é assim chamada porque a dor ataca de repente e intensamente. Embora os sintomas de feocromocitoma de bexiga sejam bastante evidentes, o diagnóstico deste tumor neuroendócrino raro pode ser perdido.

RELATO DE CASO:: Este estudo relata o caso de uma mulher diagnosticada com feocromocitoma na bexiga que sentiu a dor de cabeça trovão, desencadeada pela micção e angina como manifestação inicial.

CONCLUSÃO:: Este estudo de caso sugere que a dor de cabeça trovão e angina ocorrendo simultaneamente com a elevação da pressão de sangue repentina durante ou imediatamente após a micção são dicas importantes de diagnósticos de feocromocitoma na bexiga.

Publication types

  • Case Reports

MeSH terms

  • Angina Pectoris / etiology*
  • Blood Pressure
  • Cystectomy / methods
  • Female
  • Headache Disorders, Primary / etiology*
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Pheochromocytoma / complications*
  • Pheochromocytoma / diagnosis
  • Tomography Scanners, X-Ray Computed
  • Tomography, Emission-Computed, Single-Photon
  • Urinary Bladder Neoplasms / complications*
  • Urinary Bladder Neoplasms / diagnosis
  • Urination*