Raymundo A. Sánchez-GómezUniversity of Nuevo León, Mexico
Title: Retroperitoneal Incident in a Patient with Amebian Dysenteria
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.
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.