%0 Journal Article
%T A Case of Malignant Pheochromocytoma Detected during Fertility Treatment
%A Kazuhisa Hagiwara
%A Itsuto Hamano
%A Ayumu Kusaka
%A Hiromi Murasawa
%A Noriko Tokui
%A Kengo Imanishi
%A Akiko Okamoto
%A Hayato Yamamoto
%A Atsushi Imai
%A Shingo Hatakeyama
%A Takahiro Yoneyama
%A Yasuhiro Hashimoto
%A Takuya Koie
%A Chikara Ohyama
%J Case Reports in Urology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/646743
%X We report a case of malignant pheochromocytoma in a 35-year-old Japanese woman during fertility treatment, successfully treated with surgical excision. The patient recovered without any postoperative problems, and plasma catecholamine levels normalized. At present, 18 months after the operation, there are no signs of relapse. 1. Introduction Although the incidence of malignant tumors during fertility treatment with ovulation-inducing drugs has been described in several reports, many authors state that in the short-term, ovulation-induction treatment may not be a risk factor for ovarian cancer. Herein we describe a case of malignant pheochromocytoma detected during fertility treatment. 2. Case Report We evaluated a 35-year-old woman with no medical or family history of endocrine disease. She underwent surgical removal of the benign breast tumor at the age of 22 and underwent a surgical procedure for a uterine myoma at the age of 32. She started visiting the Department of Obstetrics and Gynecology at our hospital for fertility treatment in 2009 (31 years of age). In January 2012, a tumor of 10ˋcm diameter was identified on the inferior side of the right hepatic lobe via abdominal ultrasound screening. Malignant pheochromocytoma was diagnosed using imaging (CT, MRI) and endocrine testing, and consequently the patient was referred to our department for a surgical procedure. The subjective symptoms were as follows: no headache, no pallor of the face, no palpitations, and a sudden rise in temperature. There was no hypertension. The patients＊ characteristics recorded at the time of hospital admission were as follows: height 149.8ˋcm, weight 57.6ˋkg, BMI 25.7, blood pressure 110/65, heart rate 75ˋbpm, and body temperature 36.4∼C. The abdominal tumor was not palpable. Biochemical examination of blood showed fractionated plasma catecholamine levels as follows: adrenaline <5ˋng/mL (0每100), noradrenaline 809ˋng/mL (100每450), and dopamine 8ˋng/mL (0每20); thus, only the noradrenaline level was elevated. Fractionated urinary catecholamines were as follows: adrenaline 10ˋ米g/day (1.5每4.3), noradrenaline 568ˋ米g/day (3.4每26.9), and dopamine 685ˋ米g/day (365每961); only the noradrenaline level was elevated. Diagnostic imaging by means of abdominal CT revealed a tumor 11 ℅ 10ˋcm in size on the inferior side of the liver, which displaced the right kidney (Figure 1). Swelling was also observed in the lymph nodes around the inferior vena cava. MRI revealed an adrenal tumor exhibiting low signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging. At
%U http://www.hindawi.com/journals/criu/2014/646743/