Case report: Incidentally discovered case of pheochromocytoma as a cause of long COVID-19 syndrome

Case report: Incidentally discovered case of pheochromocytoma as a cause of long COVID-19 syndrome

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Pheochromocytomas (PCCs) are rare but potentially lethal tumors that arise from the adrenal medulla.The clinical suspicion and diagnosis of PCC can be challenging due to the non-specific nature of signs and symptoms.In many patients, infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could lead to long-term symptoms including fatigue, headaches, and cognitive dysfunction.

Here, we present the case of a patient incidentally diagnosed with an adrenal mass that proved to be a PCC after imaging was performed due to persisting complaints after coronavirus disease 2019 (COVID-19) infection.A 37-year-old male patient was referred to our center because of a right-sided inhomogeneous adrenal mass, incidentally found during a computed tomographic scan of the thorax incredibleindiatourtravels.com performed due to cough and dyspnea that persisted after COVID-19 infection.Other complaints that were present prior to COVID-19 infection included profuse sweating, dizziness, exhaustion with chronic fatigue, and concentration difficulties.

The patient had no history of hypertension, his blood pressure was normal, and the 24-h ambulatory blood pressure monitoring confirmed normotension but with the absence of nocturnal dipping.Plasma normetanephrine was 5.7-fold above the upper limit (UL) of reference intervals (738 pg/ml, UL = 129 pg/ml), whereas hiboost 4k smart link plasma metanephrine and methoxytyramine were normal at 30 pg/ml (UL = 84 pg/ml) and <4 pg/ml (UL = 16 pg/ml), respectively.

Preoperative preparation with phenoxybenzamine was initiated, and a 4-cm tumor was surgically resected.Profuse sweating as well as dizziness was resolved after adrenalectomy pointing toward PCC and not COVID-19-associated patient concerns.Altogether, this case illustrates the difficulties in recognizing the possibility of PCC due to the non-specific nature of signs and symptoms of the tumor, which in this case did not include hypertension and coincided with some of the symptoms of long COVID-19.