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Query: UMLS:C0018681 (headache)
56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 48 patients with pheochromocytoma were treated during 1965-1989. The incidence of pheochromocytoma was about 2% in hypertensive patients at same period. In this series, 31 (64.6%) had adrenal pheochromocytoma and 17 (35.4%) extra-adrenal pheochromocytoma. More than 50% of the patients showed such symptoms as hypertension, headache, sweating and palpitation. Urinary catecholamine level was significantly elevated in 97.6% of the patients. In tumor localization, CT showed an accurate diagnostic rate of 95.5% and ultrasonography 85.7%. The fluctuation of blood pressure and the amount of fluid requirement during operation in phenoxybenzamine-treated patients were lower than those in non-phenoxybenzamine-treated patients, but there was no statistically significant difference between < 14 days of treatment group and > 14 days of treatment group in phenoxybenzamine-treated patients. 47 patients underwent complete excision of tumor, except 1 patient with a gigantic tumor from the organs of Zuckerkandl. One patient died after operation.
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PMID:[Diagnosis and treatment of pheochromocytoma. Report of 48 cases]. 147 88

We describe a patient who presented frostbite in extremities in addition to characteristic symptoms, such as severe hypertension, sweating attacks, palpitations and headache. The patient was eventually diagnosed as having single extra-adrenal pheochromocytoma. The frostbite in extremities rapidly resolved after the removal of the tumor as well as other characteristic clinical symptoms. It is speculated that this frostbite might have been induced by severe continuous constriction of peripheral artery and loss of heat by frequent sweating attacks. Regarding cutaneous symptoms in this disease, pallor, acrocyanosis and cold extremities are commonly found. However, it seems that typical frostbite associated with pheochromocytoma has not been reported so far.
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PMID:[A case of extra-adrenal pheochromocytoma with frostbite in extremities]. 148 15

A 42-year-old patient with acute left-ventricular failure is described in whom pheochromocytoma was diagnosed only after prolonged and fruitless efforts. Pheochromocytoma may present without the typical features of paroxysmal or sustained hypertension, headache, increased sweating, and palpitations. Therefore, in cases of acute left-sided cardiac failure of primarily undetermined origin, pheochromocytoma should be considered in differential diagnosis.
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PMID:[Acute left heart insufficiency: possible leading symptom of a pheochromocytoma]. 157 67

A 16-year-old boy suffers from headaches. A bilateral adrenal pheochromocytoma is diagnosed and removed. After surgery, the image of bone sequestrum has disappeared. Osseous microthrombi secondary to hemoconcentration are responsible for the image of button sequestrum.
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PMID:Button sequestrum of the tibia and pheochromocytoma. 160 3

A 40-year-old male presenting with exercise-induced headaches was found to have a pheochromocytoma which was subsequently removed. His blood pressure was never recorded as elevated. He went on to develop recurrence of asthma, which had been absent for at least 20 years, 48 h postoperatively. This is the first case of pheochromocytoma manifesting as exercise-induced headache in the absence of detectable hypertension.
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PMID:Pheochromocytoma: an unusual presentation and sequela. 161 11

Extra-adrenal pheochromocytomas may arise in any portion of the paraganglion system, although they most commonly occur below the diaphragm. The most common site of occurrence of extra-adrenal pheochromocytoma is the superior para-aortic region between the diaphragm and lower renal poles. Although the traditional teaching has been that 10% of all pheochromocytomas are at extra-adrenal sites, this may be an underestimation. Extra-adrenal pheochromocytomas probably represent at least 15% of adult and 30% of childhood pheochromocytomas. They may be malignant in up to 40% of the cases, although conflicting data add to the uncertainty of this point. Patients with tumors arising at extra-adrenal sites commonly present with headache, palpitations, sweating and hypertension. The diagnosis is most often confirmed by demonstrating increased catecholamine production, usually by measurement of urinary catecholamines and/or their metabolites. CT scanning is presently the imaging procedure of choice for localization. The roles of MRI and 131I-MIBG scintigraphy in the localization process are still being determined. Thorough preoperative pharmacological preparation, attentive intraoperative monitoring and aggressive surgical therapy all have an important role in achieving the safest and most successful outcome. Complete surgical excision is the treatment of choice for primary extra-adrenal pheochromocytoma as well as recurrent or metastatic disease. When residual tumor cannot be resected, medical therapy for symptomatic relief is preferred, since radiotherapy and chemotherapy have limited effectiveness. Extra-adrenal pheochromocytomas are more likely to recur and to metastasize than their adrenal counterparts, making lifelong followup with annual determinations of catecholamine production essential.
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PMID:Extra-adrenal pheochromocytoma. 172 90

Pheochromocytomas can mimic many unrelated diseases due to their various presenting signs; they are encountered very rarely in childhood. Recently, their neuropsychiatric aspects have become a subject of interest for many workers, but most of the findings reported previously have been observed in adults. We present a case report which is unique in that it concerns a child with pheochromocytoma and psychiatric findings consisting of depression and panic disorder, which were interpreted as being directly related to, since they disappeared after the removal of, the tumor. Depression was persistent and accompanied by a constricting-type headache, while panic disorder was acute and accompanied by a migraine-type headache. Another intriguing complication encountered in our case was jaundice; we considered that it could possibly have been due to an adverse effect of catecholamines on hepatocyte function. We conclude that a pheochromocytoma can be confused with neuropsychiatric disorders in children as well as in adults and that it should be considered in the differential diagnosis of such disorders.
Headache 1991 Jul
PMID:Pheochromocytoma presenting with headache, panic attacks and jaundice in a child. 177 65

During the past 20 years (1970-90), we had 24 patients with pheochromocytoma: 19 diagnosed clinically and 5 post-mortem. Their ages ranged from 17 to 74 (mean, 43.2 years). Males (n = 14) outnumbered females (n = 10), a 1.41:1 M:F ratio. A majority were symptomatic (95%), with a typical triad of headaches, palpitations and diaphoresis. Most frequent finding was hypertension (95%). It was sustained in 60% and paroxysmal in 35%. In 6 patients (25%) pheochromocytomas were bilateral, all familial. Fifteen were solitary adrenal tumors (63%); 3 (12.5%) were extra-adrenal: 2 intra-abdominal, and 1 cardiac paraganglioma of right atrium. Of 6 familial cases, 4 were associated to Von Hippel-Lindau (VHL) disease, while 2 were multiple endocrine neoplasia (MEN-II) patients. All familial cases were bilateral and in the adrenals. There were no malignancies. Among the 19 clinical cases pre-operative Dx was made by positive urine VMA or catecholamines urine levels: (95 and 100% sensitivity respectively). Preoperative visualization by CT or MRI was done in 62% of the most recent patients. In 5 earlier cases the diagnosis was made post mortem: 3 died of cerebral hemorrhage, 1 with a pons infarct and 1 with congestive heart failure (CHF). There were 2 post-operative deaths and another died 13 years later from thyroid medullary carcinoma. Of the 19 operated, 13 (68%) were cured. Thus pheochromocytomas retain considerable morbidity and some mortality. These rare tumors constitute a clinical diagnostic challenge yet a rewarding therapeutic experience for the alert physician.
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PMID:Pheochromocytoma: a twenty year experience at the University Hospital. 177 16

A 42-year-old female with high fever and headache was admitted. Physical examination revealed hypertension, thrombocytosis with megakaryocytosis, hyperfibrinogenemia, and high level of serum noradrenaline. After operation of extramedullary pheochromocytoma, all symptoms disappeared and findings became normal. The supernatant of tumor culture showed high levels of interleukin-6.
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PMID:Interleukin-6-producing pheochromocytoma. 185 86

Pheochromocytoma is classically associated with paroxysms of headache and hypertension. Its presentation, however, may be more varied and subtle. We present a case of an adolescent female who complained of right upper quadrant and flank pain. A right adrenal pheochromocytoma was diagnosed and subsequently removed. The pertinent literature is discussed.
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PMID:Adrenal pheochromocytoma presenting with persistent abdominal and flank pain. 186 Oct 58


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