ABSTRACT
We describe a case of posterior fossa medulloblastoma in which the initial symptom was severe hypertension that evolved into a hypertensive crisis. Initial diagnostic evaluation was suggestive of both pheochromocytoma and Cushing's syndrome: elevated plasma norepinephrine and urine VMA, normal ACTH level with elevated plasma and urine cortisol, and lack of suppressibility with dexamethasone. CAT scan and cerebral angiogram subsequently revealed the presence of an intracranial mass. After surgical removal of the tumor, blood pressure pattern and endocrine abnormalities reverted to normal.
Subject(s)
Adrenal Gland Neoplasms/diagnosis , Cerebellar Neoplasms/complications , Cushing Syndrome/diagnosis , Hypertension/etiology , Medulloblastoma/complications , Pheochromocytoma/diagnosis , Adult , Cerebellar Neoplasms/diagnosis , Diagnosis, Differential , Humans , Male , Medulloblastoma/diagnosisABSTRACT
Wegener's granulomatosis has traditionally been treated with steroids and cyclophosphamide. However, sulfamethoxazole-trimethoprim has been shown to be effective. We used it to treat a patient with this disease who had pulmonary infiltrates, sinusitis, and evidence of renal disease manifested by hematuria and red cell casts. After two months of therapy with sulfamethoxazole-trimethoprim, his hematologic and radiologic values returned to normal.
