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Pheochromocytoma Presenting as a Cutaneous Manifestation: A Case Report

以皮膚表徵爲表現的嗜鉻細胞瘤:病例報告

摘要


嗜鉻細胞瘤源於交感神經系統,是一種會分泌兒茶酚胺的腫瘤。它的表現症狀一般與兒茶酚胺的過量分泌有關,包括高血壓、盜汗、頭痛、心悸、焦慮等。高血壓危象通常是嗜鉻細胞瘤的最初表現,但是嗜鉻細胞瘤的皮膚表徵並不常見。皮膚因血管收縮可能導致蒼白,但是嚴重的血管收縮卻可能產生四肢紫斑或紅斑的皮疹及肢端發紺的現象,甚至因為周邊脈搏減弱導致量不到血壓。在此種“假性休克”的情形下,卻可能因給予治療休克用的腎上腺素激性藥物而導致病情惡化甚至致命的危險。

並列摘要


Pheochromocytoma is a catecholamine-producing tumor of the sympathetic nervous system. Signs and symptoms are generally related to catecholamine excess; including hypertension, diaphoresis, headaches, palpitations and anxiety attacks. Hypertensive crisis is usually present when pheochromocytoma is suspected initially. Cutaneous manifestation of pheochromocytoma was uncommon. Pallor could be seen in association with marked vasoconstriction. However, severe vasoconstriction may cause purpuric, erythematous skin rashes and acrocyanosis over the extremities. It has also been seen to diminish peripheral pulsations, which result in non-detectable of non-invasive blood pressure (NIBP). In this ”pseudo-shock” situation, it may be treated as hypotension in shock status and adrenergic agonists are usually be administered which causes more deterioration of the disease process and fatal outcomes.

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