保存的に経過観察を行った褐色細胞腫自然破裂

Spontaneous Rupture of Pheochromocytoma Managed Successfully by the Conservative Approach

　47歳，女性。うっ血性心不全を契機に発見された後腹膜腫瘍の自然破裂が認められ，保存的に経過観察を行った。手術的療法も考慮したが，全身状態が良好でなかったことと，本人および家族の希望もありとりあえず経過観察とし，将来手術を検討する方針をとった。MIBG副腎シンチでは後腹膜腫瘍にRI取り込みは認めなかったが，血中および尿中カテコールアミン値の著しい上昇によって褐色細胞腫の診断を得た。

We report a 47-year-old female patient complaining of dyspnea and abdominal pain who had spontaneous he-matoma of the retroperitoneal space. We decided to man-age conservatively because of very poor risk of the patient. Based on the catecholamine levels in serum and urine and findings of computerized tomography, the diagnosis was ruptured pheochromocytoma. She was successfully treated with α -adrenergic blocking agent. The patient was dis-charged from the hospital and was free from clinical symp-toms.