Presentation: Sixteen year old boy presented with headache & blood pressure of 170/95. He had undergone surgery previously for bilateral pheochromocytoma ( right adrenal gland and left para renal area) at 8 years of age. He was apparently asymptomatic until last month when the headaches appeared. Diagnosis: Ultrasound abdomen revealed presence of left supra renal (para aortic) mass of 31 mm x 30 mm with plasma free nor metanephrine levels of 2250.30 pg/ml suggesting possibility of recurrent disease.
Gallium dotatate PET scan showed two well defined lesions in the left suprarenal region with abnormal somatostatin expression suggestive of recurrent pheochromocytoma. (Figure 1) Management: Pre operative Alpha blockade was initiated with Prazosin and beta blockade was provided prior to the surgery after achieving requisite alpha blockade. Maintenance normal saline infusion was used to…
