38 years old lady, Mrs. Vanitha Rani, an Anganwadi worker had been visiting many doctors with varying complaints ranging from palpitations, breathlessness, headache and fever for over 6 to 8 months. Initial investigations and treatments elsewhere did not provide any permanent relief to her.
She was referred to Vadamalayan Hospitals. Cardiological and neurological evaluations were essentially normal. A screening abdominal ultrasound reveled a right suprarenal mass. Subsequent CT Scan of the abdomen and blood investigation (metanephrines) proved it to be a rare tumor “ PHAEOCHROMOCYTOMA” of right adrenal gland.
Phaeochromocytomas are symptomatic due to release of the “ Stress Hormones “ ( adrenaline and nor adrenaline ) in excess quantity than normal into the blood stream. It is known to be a “ great mimicker ” of many diseases. These hormones when they act on the heart and blood vessels cause hypertension ( usually episodic ) and palpitation ( aware of ones own heart beat ) . When they act on the brain, they cause headache, tremors and symptoms of anxiety. Some patients even end up in the psychiatric department due to the vagueness and variety of symptoms.
She was stabilized for 14 days with adequate control of hypertention and optimization of electrolyte levels. Dr.J.Sathish Kinne, Senior Consultant Urologist along with Prof. Dr. M. Srinivasan, Senior Consultant Cardiologist ( leading the medical team) under took the procedure of right adrenalectomy. Postoperative period was stormy. However, the patient recovered completely on the 10th post operative day and till date remains asymptomatic and normotensive without any drugs.
Dr.V.Pugalagiri, Chairman and Managing Director presided over this press meet. He said, a high degree of clinical suspicion needs to be kept in the mind of evaluating physician to diagnose this condition. Multi disciplinary approach with adequate pre operative planning, cautious intra operative and post operative management was the key to the success. He concluded that this rare case will create awareness among the public about a completely curable cause of hypertension.
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