Pheochromocytoma producing multiple vasoactive peptides
M. F. Herrera, E. Stone, M. Deitel and S. L. Asa
Department of Surgery, University of Toronto, Ontario, Canada.
Pheochromocytomas may produce several vasoactive peptides. We studied a
39-year-old man who presented with paroxysmal flushing and abdominal pain
with normal blood pressure. Laboratory and radiologic studies established
the diagnosis of right adrenal pheochromocytoma, and histologic and
ultrastructural examination showed the tumor to be a typical
pheochromocytoma. Tissue culture yielded large quantities of norepinephrine
and epinephrine. However, immunohistochemical studies, tissue assays, and
in vitro cultures documented production of several peptides, including
calcitonin gene-related peptide and vasoactive intestinal polypeptide in
tumor cells. The patient has been asymptomatic after tumor resection.
Production of multiple peptides by this tumor may account for the flushing
and lack of hypertension, despite elevated catecholamine levels in this
patient.
