Unique Manifestations of Catecholamine Release in Malignant Pheochromocytoma: An Experience Within an Inpatient Palliative Care Unit
- 作者：Nicholas Anthony Coupe ; BMedSci ; MBBS (Hons) ; ncoupe@gmp.usyd.edu.au ; Judith Lacey ; MBBS (Hons) ; FRACGP ; FAchPM ; Christine Sanderson ; BMBS ; BA ; MPH ; FRACP
- 关键词：Pheochromocytoma ; palliative care ; metoclopramide ; intestinal pseudo-obstruction ; hypotension ; orthostatic ; phenoxybenzamine
- 刊名：Journal of Pain and Symptom Management
- 出版年：2012
- 期刊代码：166_08853924
- 类别：med
- 出版时间：May, 2012
- 卷：43
- 期：5
- 页码：967-972
- 文件大小：72 K
摘要
Malignant pheochromocytoma is a rare disorder. We describe the case of a 41-year-old female with disseminated metastatic pheochromocytoma who was admitted for ongoing palliative and supportive care within an inpatient palliative care unit. Predominant symptoms included severe gastrointestinal pseudo-obstruction and orthostatic hypotension Pseudo-obstruction management included percutaneous enterogastric and percutaneous enterojejunostomy tubes for gastric decompression and delivery of nutrition, respectively. Debilitating symptoms of orthostatic hypotension were mitigated with judicious fluid balance and appropriate use of adrenergic blocking agents. The potential for metoclopramide to worsen symptoms also was a significant component of management. The case presents rare features of this unusual disease and is unique for its setting within the confines of a palliative care unit.