Ruptured Abdominal Aortic Aneurysm as the Initial Manifestation of Undiagnosed Pheochromocytoma.

INTRODUCTION

Pheochromocytoma is a rare catecholamine-secreting tumor that can cause severe cardiovascular complications. Its association with ruptured abdominal aortic aneurysm is extremely rare.

CASE PRESENTATION: A 57-year-old man with no significant medical history presented with sudden abdominal pain and hemorrhagic shock. Computed tomography revealed a ruptured infrarenal abdominal aortic aneurysm, and emergency endovascular aneurysm repair was successfully performed. Preoperative imaging incidentally detected a hypervascular left adrenal mass. Although biochemical findings were borderline, 123I-metaiodobenzylguanidine scintigraphy demonstrated intense uptake, leading to a diagnosis of pheochromocytoma. After appropriate α-adrenergic blockade, elective laparoscopic adrenalectomy was safely performed, and histopathology confirmed pheochromocytoma.

CONCLUSION

This case highlights the importance of considering pheochromocytoma as an underlying cause of ruptured abdominal aortic aneurysm and demonstrates that a staged strategy with emergency endovascular repair followed by definitive endocrine surgery can be safe and effective.