Segmental Arterial Mediolysis and Pheochromocytoma: A Case Report

Editor:

Segmental arterial mediolysis (SAM) is a severe but rare nonatherosclerotic, noninflammatory vasculopathy of unknown etiology (1), and pheochromocytoma/paraganglioma (PPGL) is a well-known neuroendocrine tumor that arises from chromaffin cells of the adrenal medulla and the sympathetic ganglia (2). This study presents a case report of coincidence of these unusual entities and their potential pathophysiological link.

A 48-year-old man with type 2 diabetes mellitus, hypercholesterolemia, and hypertension presented to the emergency department with a 1-week history of bilateral flank pain. The patient’s blood pressure (BP) remained high despite compliance with previously effective medical therapy, more than 33 lbs of weight loss, and frequent episodes of profuse sweating over the past 3 months. Upon arrival, his BP was 160/110 mm Hg; on physical examination, tenderness to deep palpation and percussion in the left upper quadrant was found. Blood tests showed a C-reactive protein level of 1.01 mg/dL (normal, 0–0.59 mg/dL) and lactate dehydrogenase level of 370 UI/L (normal, 135–225 UI/L); the results of complete blood cell count, blood urea nitrogen, creatinine, electrolytes, liver function tests, thyroid function tests, coagulation tests, and urinalysis were normal...

CITA DEL ARTÍCULO J Vasc Interv Radiol . 2023 Feb;34(2):314-317. doi: 10.1016/j.jvir.2022.10.036