Pheochromocytoma, papillary thyroid carcinoma

A 53-year-old woman presented with labile and difficult to control hypertension on 3 different anti-hypertensive medications. Abdominal computed tomography and ultrasonography of the thyroid gland showed a 1.8 cm thyroid nodule. Fine needle aspiration biopsy of the thyroid nodule revealed papillary thyroid carcinoma. Serum thyroid stimulating hormone and free thyroxine, calcitonin, carcinoembryonic antigen, intact parathyroid hormone, and calcium levels were within normal limits. A 24-hour urine metanephrine showed significant elevation in urine metanephrine of approximately 3 times the upper limit of normal, and the result of 131I-metaiodobenzyleguanjdjne [131I-MIBG] scintography confirmed that the adrenal mass was pheochromocytoma. Right adrenalectomy and total thyroidectomy were performed. The final pathology was pheochromocytoma and papillary thyroid carcinoma. An analysis of c-ret porto-oncogene mutation yielded a negative result. This unusual association of 2 tumors represents a new entity

Association of a retroperitoneal liposarcoma and an adrenal medullary hyperplasia feigning a pheochromocytoma

A 45-year old woman presented with a recent paroxysmal hypertension and a flush syndrome. Physical examination revealed an abdominal mass with positive left lumbar contact. The urine metanephrine was high. The CT scan and the Magnetic Resonance imaging [MRI] showed a 10 cm retgroperitoneal tumour apart from the left adrenal gland and driving back the left kidney. The diagnosis of ectopic pheochromocytoma was suspected and the patient was operated. A tumour resection widened to the left adrenal gland and to the kidney was performed The specimen histology showed a well-differentiated liposarcoma associated to an adrenal medullary hyperplasia [AMH] Postoperatively blood pressure was stabilizsed at normal levels. The review of literature show that AMH mimicking a pheochromocytoma is rare and its association with a giant retroperitoneal liposarcoma has never been reported before

Feocromocitoma: experiencia en el diagnóstico y tratamiento del primer caso detectado en baja California Sur / Pheochromocytoma: experience in diagnosis and treatment of the first case detected in baja California Sur

El feocromocitoma es una causa poco frecuente de hipertensión que lleva a la muerte si no es diagnósticado. Presentamos el caso de un hombre de 33 años con historia de dos años de crisis hipertensivas aisladas que paulatinamente se hacen más frecuentes. Tres meses antes de ser valorado en nuestro hospital se agregó un cuadro anginoso. La impresión diagnóstica inicial fue de feocromocitoma, corroborándose por laboratorio y gabinete. Responde en cinco días al tratamiento con prazocina, con lo que se pudo resecar un tumor completo de 190 g. El estudio histopatológico lo confirma. Todas las manifestaciones clínicas desaparecieron durante el seguimiento y cursa normotenso sin ningún antihipertensivo, por lo que se considera curado

Separación de aminas biogénicas mediante cromatografía líquida de alta resolución / High-performance liquid chromatographic determination of biogenic amines

En este trabajo se han compilado los distintos modos cromatográficos y sistemas de detección utilizados en la cromatografía líquida de alta resolución de aminas biogénicas. Se indican las características generales del intercambio catiónico, fase reversa, fase reversa de pares iónicos y cromatografía de partición con fase reversa de pares iónicos. También se analizan comparativamente la detección UV, detección fluorimétrica usando fluorescencia nativa o bien derivatización pre- y postcolumna y detección electroquímica de gran utilidad para esta extensa familia de compuestos. Se dan ejemplos de aplicación de interés en el campo bioquímico-clínico, con el análisis de ácido homovainillínico, ácido 3,4-dihidroxifenilacético y ácido 5-hidroxiindolacético en líquido cefalorraquídeo, metanefrinas, ácido 3,4-dihidroxifenilacético, catecolaminas, ácidos urinarios y 3-metoxi-4-hidroxifenilglicol en orina, catecolaminas y 3-metoxi-4-hidroxifenilglicol en plasma, catecolaminas, 3-metoxi-4-hidroxifenilglicol y otros neurotransmisores en cerebro de rata. Se discuten, también, los tratamientos previos requeridos especialmente para orina y plasma, así como las condiciones de conservación y su incidencia en los resultados obtenidos

Iron deficiency anemia and catecholamine metabolism.

To assess the effects of iron therapy on platelet monoamine oxidase (MAO) activity and urinary excretion of total metanephrines (MN) in infants and young children with iron deficiency anemia, 24 subjects were tested before and after one month of oral iron treatment. Thirteen healthy children comprised the control group. In the control group, platelet MAO level was 0.21 +/- 0.02 U/mg protein (mean +/- SE), urinary total metanephrine was 2.51 +/- 0.47 micrograms/mg creatinine. In cases with iron deficiency, mean platelet MAO level was 47.6% lower (p less than 0.005) whereas mean urinary metanephrine plus normetanephrine (MN-NMN) was only 20.7% lower (p greater than 0.05) than the control values. After one month, the anemic patients receiving oral iron therapy showed a significant increase in hemoglobin concentration, per cent transferrin saturation and platelet MAO activity (p less than 0.05). However, urinary metanephrine excretion was found to be lower in this group when compared to the metanephrine levels in iron deficiency before the medication (p less than 0.05). Although hemoglobin and transferrin saturation did not return to normal levels, these findings suggested that platelet MAO activity increased and urinary excretion of metanephrines decreased after iron medication.