Year: 2025
Type: article
Study design: Case Report
Abstract: Pheochromocytoma is a rare catecholamine-secreting tumor arising from the adrenal medulla. Despite how rare the tumor is, early recognition is critical due to its potential to cause life-threatening complications. Symptoms include episodic hypertension, headaches, and palpitations. Unusual laboratory findings, such as leukocytosis and eosinophilia, are rarely associated with this condition. We report the case of a 42-year-old female presenting with intermittent headaches, episodic hypertension, palpitations, and other symptoms. Initial laboratory investigations showed significant leukocytosis (19.8 x10⁹/L), thrombocytosis (735 x10⁹/L), and eosinophilia (2.7 x10⁹/L), which later reached 5.10 x10⁹/L. Elevated plasma and urinary metanephrines confirmed the diagnosis of pheochromocytoma. CT abdomen showed a large right adrenal mass (10.2 × 9.4 × 9.0 cm) with cystic and hemorrhagic features. Workup to exclude infectious, allergic, and myeloproliferative causes of eosinophilia and leukocytosis was unremarkable. The patient was stabilized medically with alpha- and beta-blockers and scheduled for preoperative embolization followed by laparoscopic adrenalectomy. Pheochromocytoma may present with atypical hematologic abnormalities such as eosinophilia and leukocytosis. This case highlights a rare association between pheochromocytoma and both eosinophilia and leukocytosis. Possible mechanisms include tumor-related secretion of pro-inflammatory cytokines like IL-6 or catecholamine-mediated bone marrow stimulation. Recognition of such atypical presentations can prevent diagnostic delays and facilitate early intervention. This case also highlights an unusual radiological appearance of pheochromocytoma, a large, cystic adrenal mass with internal hemorrhagic changes in a patient with uncontrolled hypertension. Clinicians should consider the diagnosis of phaeochromocytoma in patients with unexplained secondary hypertension and abnormal white cell counts, in the absence of infection or neoplastic disease.
Source: Cureus
DOI: 10.7759/cureus.98160
Authors: Nouf Alnaqeeb, Mohamed M Abd Elhamid, Ihab AImagdub, Randa Ali
Institution: Shaikh Khalifa Medical City
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416829552