Krister Blær Jónsson¹

Eiríkur Orri Guðmundsson²

Margrét Sigurðardóttir³

Jón Jóhannes Jónsson^1,4

Helga Ágústa Sigurjónsdóttir^1,5

¹Faculty of Medicine, University of Iceland, ²department of urology, Landspítali National University Hospital of Iceland, ³department of pathology, Landspítali National University Hospital of Iceland, ⁴department of genetics, Landspítali National University Hospital of Iceland, ⁵department of internal medicine, Landspítali National University Hospital of Iceland.

Correspondence: Krister Blær Jónsson, kristerb@landspitali.is

Key words: pheochromocytoma, paraganglioma, resistant hypertension, neuroendocrine tumor, metanephrine.

 

We report a case of a man with a 30-year history of treatment-resistant hypertension, hydropoiesis, tachycardic spells and dysgeusia. Despite repeated visits to the emergency department and work-up in an out-patient clinic, the diagnosis was unknown. Three years prior to remittance to an endocrinologist, the hypertension worsened, and he developed diabetes type-II. Further work-up revealed a 3 cm extra-adrenal pheochromocytoma, a paraganglioma. After surgical removal of the tumor, he is without medication and symptom free.

Pheochromocytoma and paraganglioma are rare causes of hypertension, estimated to explain 0.1-0.6% of all cases, but nonetheless an important diagnosis to make, due to serious side effects.