|
|
|
Goubaa Mohamed MD Djerba Tunisia
|
|
|
| This is a
56-year-old female with a 2-week history of nausea, vomiting, abdominal
pain, Weight loss, fatigue, and history of intermittent hypertension.
She was afebrile. Physical examination revealed severe hypertension
: 32/17. |
Patiente agée
de 56 ans, presentant depuis 2 semaines des singes de fatigue et perte
de poids, douleur abdominale avec nausées et vomissements,
sans fièvre, avec aussi des pics hypertensifs. l'examen physique
révèle une hypertension sévère a 32/17. |
|
|
| CT scan |
Le scanner |
 |
|
| Click on the image below |
 |
| Cliquez sur les images en
bas |
CT scan
Scanner
|
| A 2,4 x 3 cm mass is
identified at the dome of the right kidney (Film .1). This is seen
on echography and CT scan images (denoted by red calipers >
<, Scan 3). The mass is heterogeneous with a
mixed echogenicity but predominantly hypoechoic. Other abnormalities
* are identified > Click here. |
Une masse
de 2,4 x 3 cm est identifiable au niveau du dôme du rein droit.
Cette masse est visible en échographie mais aussi au scanner
(délimitée par les clippers rouge >
<sur la troisième image). D'autres anomalies
* sont visible > cliquez
ici |
|
| Phaeochromocytoma |
phéochromocytome |
 |
|
diagnosis :
Over 90% of pheochromocytomas are located within the adrenal glands
and 98% within the abdomen. Extra-adrenal pheochromocytomas develop
in paraganglion chromaffin tissue of the sympathetic nervous system.
. Phaeochromocytomas produce catecholamines and thus patients
present with hypertension which may be intermittent. Most are
benign but 10 pet cent are malignant, 10 pet cent bilateral and
10 pet cent are extra-adrenal. Approximately 40 per cent of extra-adrenal
phaeochromocytomas are missed, of which 5 pet cent are multiple.
Most of the extra-adrenal phaeochromocytomas lie in the abdomen
or pelvis.
Sonography :
Sonographic appearances are those of a well-defined homogeneous
hypoechoic mass in approximately 50 pet cent of patients. However
the mass may be complex or even cystic (16 pet cent) and hyperechoic
to the renal parenchyma (approximately 20 pet cent). Most phacochromocytomas
are 5 to 6 cm in size at presentation.
differential
diagnosis :
* Adrenal hyperplasia
* Haemorrhage.
* Lipoma.
* Adenoma
* Fibroma.
* Leiomyoma.
* Haemangioma.
* Myelolipoma.
* Osteoma.
* Neurofibroma.
*Carcinoma.
* Sarcoma
* Neuroblastoma.
* Metastases : breast, lung, ovary, gastrointestinal tract, melanoma
and kidney.
|
|
English
Français
Arabic
Français
Arabic
©
MedicalSONO.net