We report the case of a 20-year-old man who consulted for hypertensive crisis of one year duration, accompanied by profuse sweating, generalized redness, headache and occasionally low back pain.
Blood pressure levels reached 230/110 mmHg, often triggered after physical exertion.
Physical examination revealed erythema malar and palm, which disappeared with digital pressure.
Laboratory tests revealed elevated catecholamines and metanephrines in 24-hour urine: noradrenaline excretion of 7515.77 nmol/24 h (< 504), dopamine 4298/2476 nmol/24 h
Abdominal ultrasound showed an 8 cm retroperitoneal mass with heterogeneous echogenicity and marked vascularization.
This finding was confirmed by abdominal-pelvic computerized axial tomography (CAT), which confirmed the existence of a retroperitoneal mass 8 x 4 cm by inferior vena cava bifurcation aorta artery and inferior border encompassing the aorta.
Given the CT findings, cavography was performed to assess resectability, observing an infrarenal intracaval repletion defect of 2 cm in diameter.
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Once the tumour was suspected, a beta-blockade and alpha-adrenergic block were performed and a block resection of the tumor was performed.
The postoperative course was uneventful, the symptoms disappeared and the determinations in plasma and urine were normalized.
The anatomopathological diagnosis confirmed the suspicion of well-defined encapsulated paralysis with low proliferative index (ki 67: 5-7
On medical exam, 123I-MI scintigraphy showed no signs of residual or distant disease.
Due to the lack of data justifying adjuvant chemotherapy, periodic follow-up was decided.
