Abstract
Background
Clinical manifestations of pheochromocytoma can be highly variable and life-threatening,
particularly affecting the endocrine and cardiovascular systems. We report an unusual
case of adrenal pheochromocytoma.
Case Description
A 54-year-old woman with long-standing diabetes and prior cardiovascular events presented
with episodic chest pain and labile blood glucose levels. Imaging revealed a left
adrenal mass and biochemical studies confirmed excessive catecholamine and adrenocorticotropic
hormone (ACTH) secretion, with failure of cortisol suppression. Adrenalectomy confirmed
pheochromocytoma with ectopic ACTH production. Postoperatively, the patient achieved
complete biochemical remission and glycemic stability on metformin monotherapy.
Conclusion
This case highlights the diagnostic complexity of pheochromocytoma with atypical presentations.
ACTH cosecretion can mimic Cushing's syndrome and precipitate metabolic crises such
as diabetic ketoacidosis. Early recognition and surgical intervention are essential
for improving clinical outcomes and achieving long-term stability.
Keywords
pheochromocytoma - ACTH secretion - diabetic ketoacidosis - acute coronary syndrome
- adrenal tumor - endocrine disorders
