A 65-year-old man presented to a hospital complaining of memory disturbance after
a motor vehicle accident. While driving, he had had an episode of loss of consciousness
accompanied by blurred vision. He had had headache and vertigo for several months.
His medical history included hypertension, diabetes mellitus, and atrial fibrillation.
However, he had discontinued treatment of his own accord a few years previously. Computed
tomography showed intracranial and left adrenal lesions. He was therefore referred
to our hospital for diagnosis. The patient described symptoms of headache, palpitations,
and lightheadedness and had a tremor. His blood pressure on admission was 175/80 mmHg
and fluctuated markedly thereafter. Contrast-enhanced computed tomography of the abdomen
revealed a 6-cm necrotizing left adrenal neoplasm. Axial fluid-attenuated inversion
recovery magnetic resonance imaging showed hyperintensity in both posterior parietal
lobes with intracranial hemorrhage within larger regions of vasogenic edema on the
left (Figure A).
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References
- Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline.J Clin Endocrinol Metab. 2014; 99: 1915-1942
- Intracranial epidural metastases of adrenal pheochromocytoma: a rare entity.World Neurosurg. 2018; 114: 235-240
- A reversible posterior leukoencephalopathy syndrome.N Engl J Med. 1996; 334: 494-500
Article info
Publication history
Published online: April 12, 2022
Accepted:
April 6,
2022
Received:
February 24,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
