A case report of a giant adrenal tumor; a delayed diagnosis or missed diagnosis

Pheochromocytoma is a rare catecholamine secreting tumor originating usually from adrenal medulla and produces signs and symptoms due excessive catecholamine secretion from tumor. A young male patient of 32 year age presented with febrile episodes, dullache on left upper quadrant of abdomen, episodic headache and weakness for last 2 months. Clinical suspicion of pheochromocytoma was confirmed by vitals monitoring and CT scan of abdomen. After having two weeks of preoperative preparation with alpha blocker and beta–blocker, open surgical removal of pheochromocytoma was done. Preoperative fluctuation of BP was well managed by IV fluid overload, intravenous Phentolamine, intravenous Esmolol and intravenous Ephedrine. Postoperative recovery was uneventful and BP regains to normal range from 1st postoperative day. Pheochromocytoma is a rare cause of hypertension. If the diagnosis of pheochromocytoma is delayed or missed, the consequences could be disastrous, even fatal; however, if a pheochromocytoma is identified, it is potentially curable, as being one of the causes of surgically correctable hypertension.