Goubaa Mohamed MD Djerba Tunisia

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--- Arabic
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


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CT scan


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



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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.
* Sarcoma
* Neuroblastoma.
* Metastases : breast, lung, ovary, gastrointestinal tract, melanoma and kidney.