Pheochromocytoma triggered by coronavirus disease 2019: a case report.

BACKGROUND: Coronavirus disease 2019 is an infectious disease with many presentations, and many of its effects on the human body are still unknown. Pheochromocytoma is a neuroendocrine tumor that may occur sporadically or be a manifestation of a hereditary disease line multiple endocrine neoplasia type 2. CASE PRESENTATION: In this study, we report a case of an Iranian patient infected with coronavirus disease 2019, causing unusual presentations of pheochromocytoma, including myocarditis and cerebrovascular involvement. CONCLUSIONS: We discovered a case of pheochromocytoma as an unusual presentation of COVID-19. In further investigations we also discovered thyroid medullary carcinoma and at the end MEN 2 syndrome was diagnosed. After proper treatment many symptoms were eliminated.

Type A aortic dissection and pheochromocytoma: an indirect consequence of the Covid-19 pandemic.

Type A aortic dissection is a cardiovascular emergency. Its incidence seems to have increased in the last few years; it is not clear whether this is a consequence of the ageing population or better awareness of the diagnosis (Erbel R, Alfonso F, Boileau C, Dirsch O, Eber B, Haverich A et al.; Task Force on Aortic Dissection, European Society of Cardiology. Diagnosis and management of aortic dissection Task Force on Aortic Dissection, European Society of Cardiology. Eur Heart J 2001;15;22:1642-81). Acute type A aortic dissection is often lethal without urgent surgical treatment with mortality rates of around 17% (Conzelmann LO, Weigang E, Mehlhorn U, Abugameh A, Hoffmann I, Blettner M et al. Mortality in patients with acute aortic dissection type A: analysis of pre- and intraoperative risk factors from the German Registry for Acute Aortic Dissection Type A (GERAADA). Eur J Cardiothorac Surg 2016;49:e44-e52). Pheochromocytomas are rare tumours, though often asymptomatic, they could be lethal if left untreated. The incidence is around 0.6 per 100,000 persons per year. The association of both aortic dissection and pheochromocytoma is rare. Here, we report a case of a 36-year-old patient with pheochromocytoma and hypertension, whose delay of surgery due to the Covid-19 pandemic led to acute type A aortic dissection.

Simultaneous unilateral laparoscopic adrenalectomy for pheochromocytoma and thyroidectomy in MEN 2A and MEN 2B syndrome.

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Inherited/Genetically-Associated Pheochromocytoma/ Paraganglioma Syndromes and COVID-19.

In some subjects with inherited pheochromocytoma/paraganglioma (PPG) syndromes, hypoxia-inducible factor 1 alpha (HIF1α) stabilization/activation could lead to an increase in angiotensin converting enzymes (ACE). This would result in the stimulation of angiotensin (AT) II production and, hence, reduce the availability of ACE 2. The latter would provide decreased numbers of binding sites for the spike protein of SARS-CoV-2 and, therefore, result in less points of viral entry into cells. Thus, subjects with HIF1α-associated PPG syndromes may benefit from an inherent protective effect against COVID-19. Such an implication of HIF1α vis-à-vis COVID-19 could open ways of therapeutic interventions.

Catecholaminergic Crisis After a Bleeding Complication of COVID-19 Infection: A Case Report.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents in some cases with hemostatic and thrombotic complications. Pheochromocytomas are unusual, though potentially lethal tumors. Herein we describe the first case of hemorrhage in a pheochromocytoma related to SARS-CoV-2 infection. A 62-year-old man consulted for syncope, fever, and palpitations. He was diagnosed with SARS-CoV-2 pneumonia and presented with a hemorrhage in a previously unknown adrenal mass, which resulted in a catecholaminergic crisis. Medical treatment and surgery were required for symptom control and stabilization. We hereby alert clinicians to watch for additional/unreported clinical manifestations in COVID-19 infection.

Pheochromocytoma presenting as fulminant myocarditis mimicking COVID-19 pneumonia (preprint)

Adrenergic myocarditis is a very rare manifestation of pheochromocytoma. On the other hand, due to the pandemic situation, COVID-19 pneumonia is now considered a differential diagnosis of patients with dyspnea. This case illustrates diagnostic difficulties of such uncommon disease during this pandemic situation.