Head & neck · 2015
Intraoperative hypertensive crisis due to a catecholamine-secreting esthesioneuroblastoma.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Salmasi Vafi, Schiavi Adam, Binder Zev A, Ruzevick Jacob, Orr Brent A, Burger Peter C, Ball Douglas W, Blitz Ari M, Koch Wayne M, Ishii Masaru, Gallia Gary L
Аннотация
BACKGROUND: Although uncommon, esthesioneuroblastomas may produce clinically significant amounts of catecholamines.
METHODS: We report a patient with a catecholamine-secreting esthesioneuroblastoma who developed an intraoperative hypertensive crisis.
RESULTS: A patient with a history of hypertension was referred to our skull base center for management of a residual esthesioneuroblastoma. A staged endonasal endoscopic approach was planned. At the conclusion of the first stage, a hypertensive crisis occurred. Workup revealed elevated levels of serum and urinary catecholamines. The patient was treated with alpha adrenoceptor blockade before the second stage. Serum catecholamine levels after this second stage were normal. On immunohistochemical analysis, the tumor cells were found to be positive for tyrosine hydroxylase, the rate limiting enzyme in catecholamine synthesis, and achaete-scute homologue 1, a transcription factor essential in the development of olfactory and sympathetic neurons.
CONCLUSION: Catecholamine production should be considered in the differential of unexpected extreme hypertension during surgical resection of esthesioneuroblastoma.
METHODS: We report a patient with a catecholamine-secreting esthesioneuroblastoma who developed an intraoperative hypertensive crisis.
RESULTS: A patient with a history of hypertension was referred to our skull base center for management of a residual esthesioneuroblastoma. A staged endonasal endoscopic approach was planned. At the conclusion of the first stage, a hypertensive crisis occurred. Workup revealed elevated levels of serum and urinary catecholamines. The patient was treated with alpha adrenoceptor blockade before the second stage. Serum catecholamine levels after this second stage were normal. On immunohistochemical analysis, the tumor cells were found to be positive for tyrosine hydroxylase, the rate limiting enzyme in catecholamine synthesis, and achaete-scute homologue 1, a transcription factor essential in the development of olfactory and sympathetic neurons.
CONCLUSION: Catecholamine production should be considered in the differential of unexpected extreme hypertension during surgical resection of esthesioneuroblastoma.
Предметные рубрики MeSH
Antihypertensive AgentsBiopsy, NeedleCatecholaminesEndoscopyEsthesioneuroblastoma, OlfactoryFollow-Up StudiesHumansHypertension, MalignantImmunohistochemistryIntraoperative ComplicationsMagnetic Resonance ImagingMaleMiddle AgedNasal CavityNose NeoplasmsRare DiseasesRisk AssessmentSkull Base NeoplasmsTreatment Outcome