Feocromocitoma: a propósito de 3 casos clínicos
Palavras-chave:
feocromocitoma, hipertensão arterial, metanefrinaResumo
Os feocromocitomas são tumores neuroendócrinos raros que,
apesar de uma apresentação clínica altamente variável, muitas
vezes surgem associados a episódios de cefaleias, palpitações,
sudorese e hipertensão arterial. As complicações cardiovasculares, sérias e potencialmente fatais, devem-se a efeitos das
catecolaminas segregadas.
O estudo bioquímico destes tumores está indicado não apenas nos doentes sintomáticos, mas também em indivíduos com
acidentalomas supra-renais ou com predisposições genéticas
identificadas (Síndrome de Von Hippel Lindau, Neoplasia Endócrina Múltipla, tipo 2, Neurofibromatose-1).
Nesse sentido, os autores apresentam três casos clínicos
em que foi feito o diagnóstico bioquímico de feocromocitoma:
o primeiro referente a um jovem de 30 anos admitido para investigação no contexto de um acidentaloma supra-renal direito
com cerca de 6 cm de diâmetro; o segundo, uma jovem de 25
anos no decurso do estudo de hipertensão arterial e o terceiro
uma mulher de 59 anos, com antecedentes pessoais irrelevantes, que apresentava um nódulo supra-renal direito num exame
imagiológico de rotina.
Recorreu-se a métodos imagiológicos como tomografia computorizada (TC), ressonância magnética nuclear (RMN) e cintigrafia I
123-MIBG para localização dos tumores.
Após terapêutica pré-operatória adequada, para bloquear os
efeitos das catecolaminas segregadas, os doentes foram submetidos a laparoscopia, que decorreu sem intercorrências.
O prognóstico é excelente
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