Hemorrhage Into a Pheochromocytoma

WE describe the clinical course of a patient and discuss a number of the associated pharmacophysiological effects of massive hemorrhage into a pheochromocytoma. Report of a Case A spontaneous hemorrhage into a unilateral adrenopheochromocytoma developed in a previously healthy 28-year-old woman. This led to fulminating pulmonary edema and cardiac failure, which were complicated by disseminating intravascular coagulation resulting in microinfarcts and ischemic necrosis of the brain. In the emergency room, she was nauseated and was vomiting. On examination, her vital signs were blood pressure (BP), 120/80 mm Hg; pulse rate, 124 beats per minute; and respirations, 16/min. She was not in distress. Her oropharynx was unremarkable and her chest was clear. Her abdomen was unremarkable. Within one hour cyanosis and copious, frothy pink hemoptysis developed. A chest x-ray film showed fulminant pulmonary edema. Her blood gas values on 100% oxygen were Pao₂, 45 mm Hg; Pco₂, 29 mm