A pediatric pheochromocytoma presented as a multi-organ failure syndrome and brief discussion of the related medical literature.

A 9 years old boy presented to our hospital complaining of night sweat and weight loss (5kg) for 3 months followed by cough, nausea, vomiting and malaise for two weeks. During that time he was found to have continuous hypertension. The clinical, electrocardiogram (ECG), renal scintigraphy and biologic findings suggested multi organ-failure syndrome. Computed tomography (CT) and ultrasound revealed a right adrenal tumor. Vanillymandelic acid (VMA) in the 24 hours urine sample was not elevated. Pheochromocytoma was suspected given his hypertension, ultrasound and CT findings. Pre-operative stabilization of his blood pressure was achieved over the following 4 weeks, after treatment with alpha -and beta- blockers, sodium nitroprusside and diuretics. Subsequently, right adrenalectomy was successfully performed. Histological examination showed that the tumor was a pheochromocytoma. Technetium-99m-ethylene dicysteine ((99m)Tc-EC) renal scintigraphy confirmed severe kidney function impairment.

CONCLUSIONS

Our pediatric case of pheochromocytoma was first presented, with cardiac, renal and hepatic failure which prompted us to the diagnosis of pheochromocytoma.