Malignant Pheochromocytoma of the Adrenal Medulla (Paraganglioma)

Abstract

It is customary to associate pheochromocytoma of the suprarenal gland with attacks of paroxysmal hypertension in which pallor, cold, clammy extremities, palpitation, ‘pounding’ of the pulse, particularly in the head and neck, and severe headache are constant findings, and in which a wide variety of other signs and symptoms of sympathomimetic type are common. Such attacks may be sufficiently severe to lead to death from cerebral hemorrhage, edema of the lungs, or coma symptomatically resenv bling that of uremia. Despite the fact that only a few more than 100 cases of pheochromocytoma of the adrenal have been reported in the literature (1), the above syndrome associated with paraganglioma of a benign type is well understood, although not always recognized. The clinical findings and course of malignant forms of the condition are not so well distinguished, as only 8 cases, including that herein described, are on record, not one of which has exhibited the acute attacks of widely fluctuating blood pressure and associated sympathetic phenomena above noted.