Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 66-year-old man with colorectal carcinoma and liver-only metastases underwent radioembolization using Y-loaded, resin-based microspheres. One day after radioembolization, the patient experienced severe hypertension and multiple seizures. On MRI, symmetric edematous areas in the cerebellum and the parietal and occipital lobe were observed, a typical finding for posterior reversible encephalopathy syndrome (PRES). The PRES is associated with, for example, renal failure or blood pressure fluctuations leading to cerebral endothelial dysfunction. Antihypertensive and antiepileptic therapies led to normotensive blood pressure and neurological remission. Therefore, newly developed neurological symptoms accompanied by high blood pressure fluctuations after radioembolization should lead to PRES as differential diagnosis.
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PMID:Posterior Reversible Encephalopathy Syndrome After 90Y-Resin Microspheres Radioembolization. 3197 87

Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological entity that is manifested by characteristic magnetic resonance imaging (MRI) depictions of subcortical/cortical hyperintensities in the parieto-occipital lobes. Paroxysmal hypertension, headache, and palpitation are the most common clinical manifestations of pheochromocytoma, which are catecholamine-secreting enterochromaffin tumors. PRES is a rare complication of pheochromocytoma. Herein, we describe a 44-year-old woman who presented with postoperative confusion and headache. MRI images showed multiple asymmetrical hyperintensities with surrounding edema and contrast enhancement, predominantly in the right parietal lobe, left cerebellar hemisphere, and dentate nuclei, in favor of hemorrhagic metastases. The results of further investigations, including abdominopelvic computed tomography and the 24-hour urine test for metanephrine and normetanephrine, were in favor of a pheochromocytoma. The patient was scheduled for adrenalectomy and histopathologic examination of the tissue, which confirmed the diagnosis. Surprisingly, her symptoms and neuroimaging abnormalities improved significantly without any treatment during the follow-up period. Based on these findings, the diagnosis of PRES was considered, and the patient was followed. She was symptom-free at 3 years' follow-up. The literature contains only four case reports of PRES as a complication of pheochromocytoma; however, all these cases had bilateral symmetrical hemispheric involvement and occurred during childhood and adolescence.
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PMID:Atypical Posterior Reversible Encephalopathy Syndrome as the First Presentation of a Pheochromocytoma: A Case Report. 3328 Dec 66


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