Key result
Bladder paraganglioma resection substantially improves malignant hypertension in a young adult.
Why the study?
The clinical presentation of malignant hypertension and stress cardiomyopathy with an underlying catecholamine-producing tumor is uncommon and requires recognition for appropriate diagnosis and management.
Case Report (n=1)
May support resection for malignant hypertension from catecholamine-producing bladder paraganglioma; leaves open need for confirmatory studies.
A 39-year-old man with chronic hypertension presented with perioperative malignant hypertension while undergoing induction for elective surgery. He was treated with intravenous antihypertensives. He reported several years of episodic chest pain, palpitations, and diaphoresis. Transthoracic echocardiogram demonstrated new-onset cardiomyopathy. Urinary and serum catecholamines were measured and the pattern of catecholamine levels suggested an extra-adrenal source. Computed tomography of the abdomen showed a contrast-enhancing mass in the bladder suspicious for metastatic paraganglioma. The patient had surgical resection with substantial improvement in his hypertension. The presence of labile hypertension and acute cardiomyopathy precipitated by stress should prompt evaluation for a catecholamine-producing tumor and appropriate genetic testing.
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Rao et al. (2022) conducted a case report in Malignant hypertension and stress cardiomyopathy (n=1). Surgical resection was evaluated. Surgical resection of a catecholamine-producing bladder paraganglioma resulted in substantial improvement of malignant hypertension in a 39-year-old man.
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