
Raymundo A. Sánchez-Gómez
University of Nuevo León, MexicoTitle: Retroperitoneal Incident in a Patient with Amebian Dysenteria
Abstract
Pheochromocytomas and paragangliomas (PPGL)
are tumors that arise from chromaffin cells. These tumors produce
catecholamines and cause hypertension in 90% of cases. More than 70% are solitary
tumors, do not recur or metastasize, and are likely to be cured with early
diagnosis and treatment. On the other hand, 10-30% metastasize and are
diagnosed as malignant.
A 23-year-old
female who comes to the emergency service for 3 days of evolution with watery
diarrhea; she refers 3-4 episodes per day and abdominal colic pain with 1
episode of hematochezia. Within her medical history, she referred systemic
arterial hypertension of 3 years of diagnosis.
Upon admission,
she was hemodynamically unstable, tachycardic, generalized pallor and capillary
filling > 2 seconds. During her hospitalization,
within the lower gastrointestinal (GI) bleeding approach, abundant
polymorphonuclear cells, moderate erythrocytes, and the presence of Entamoeba
histolytica cysts and trophozoites were found by microscopic examination. In
addition, abdominal CT scan was performed, finding a retroperitoneal
para-aortic mass with contrast enhancement of 5 x 5 x 5.2 cm.
Due to suspicion of secondary hypertension
and abdominal incidentaloma, we decided to perform plasma metanephrines with a
result of free metanephrines 26 pg / mL (?57 pg / ml), free normetanephrines
1,112 pg / mL (?148 pg / mL) and total metanephrines 1,138 pg / mL (?205 pg /
mL) confirming the diagnosis of paraganglioma. We decided to perform
metaiodobenzylguanidine (MIBG) labeled to iodine-131 and in case of ruling out
metastases, definitive surgical management.
PPGLs are rare neuroendocrine tumors and
are easily diagnosed using imaging and biochemical tests. The vast majority of
cases can be cured with surgical treatment. On the other hand, there are
problems in the management of malignant disease, which is why it is important
to identify genetic mutations and early diagnostic markers for the development
of effective molecular treatments.
Biography
Raymundo Sanchez
currently in the second year of the Endocrinology residency at Hospital
Universitario in Monterrey, Mexico.
I have
participated in national and international congresses, the last one during the
Pituitary Society Preceptorship Course participating with an oral case report.
Areas of interest diabetes and obesity.