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JULIUS BAUER, ELMER BELT, PAROXYSMAL HYPERTENSION WITH CONCOMITANT SWELLING OF THE THYROID DUE TO - PHEOCHROMOCYTOMA OF THE RIGHT ADRENAL GLAND. CURE BY SURGICAL REMOVAL OF THE PHEOCHROMOCYTOMA, The Journal of Clinical Endocrinology & Metabolism, Volume 7, Issue 1, 1 January 1947, Pages 30–46, https://doi.org/10.1210/jcem-7-1-30
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Abstract
THE CLINICAL picture, pathology and treatment of tumors, originating from the chromaffin tissue of the adrenal medulla (pheochromocytoma), or from the genetically and morphologically identical chromaffin tissue adjacent to the sympathetic chain (paraganglioma), and their symptomatology, the suprarenal sympathetic syndrome, is well known today, Belt and Powell (7), Wells and Boman (46), and Howard and Barker (25).
The case we are about to report is unusual since the patient presented a symptom hitherto not described in the literature, i.e., paroxysmal swelling of the thyroid gland, accompanying and simultaneous with paroxysmal hypertensive crises. Furthermore, there were extremely rapid and excessive variations in blood pressure, which usually are not associated with the syndrome.
In 1934 Belt and Powell (7) reviewed the sixty cases already reported in the literature, and simultaneously presented a case of their own in which the pheochromocytoma, weighing 1000 gm. and containing 2 gm. of adrenalin per 100 gm. of tissue, replaced the right adrenal. In the same year Bauer and Leriche (4) reported the sixth surgically-cured case of a chromaffin tumor. This tumor was a paraganglioma situated close to a normal left adrenal gland. During the last decade the number of diagnosed and successfully-treated cases has risen considerably. Up to 1939, 103 chromaffin tumors were recorded, either diagnosed or found at necropsy, Brunschwig and Humphreys (12). Of these, 43 were found in the right adrenal, 34 in the left adrenal, 13 in both adrenals, and 13 were situated entirely outside the adrenal glands. In 1942, Kirshbaum and Balkin (27) collected 116 cases. In 1943, Hyman and Mencher (26) found a total of 35 surgically-treated cases of chromaffin tumor reported in the world's literature. Four of these were paragangliomas not involving the adrenal glands. The operative mortality in this series of 35 cases was 5. The tumor was malignant in only one patient who later died of metastases.
