Thunderclap-like headache triggered by micturition and angina as an initial manifestation of bladder pheochromocytoma

a case report

Authors

  • You Jin Han Kosin University College of Medicine
  • So Young Ock Kosin University College of Medicine
  • Eun Jung Kim Kosin University College of Medicine
  • Ho Sik Shin Kosin University College of Medicine
  • Yeon Soon Jung Kosin University College of Medicine
  • Hark Rim Kosin University College of Medicine

Keywords:

Pheochromocytoma, Headache disorders, primary Micturition, Angina pectoris, Catecholamines

Abstract

CONTEXT: Pheochromocytoma is a catecholamine-producing tumor characterized by hypertension, headache, tachycardia, excessive diaphoresis and angina. The thunderclap headache is so named because the pain strikes suddenly and severely. Although the symptoms of bladder pheochromocytoma are rather evident, the diagnosis of this rare neuroendocrine tumor can be missed. CASE REPORT: This study reports the case of a woman diagnosed with bladder pheochromocytoma who experienced thunderclap headache triggered by micturition and angina as an initial manifestation. CONCLUSION: This case study suggests that thunderclap headache and angina occurring concurrently with sudden blood pressure elevation during or immediately after micturition are important diagnostic clues for bladder pheochromocytoma.

Downloads

Download data is not yet available.

Author Biographies

You Jin Han, Kosin University College of Medicine

MD. Resident Physician, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

So Young Ock, Kosin University College of Medicine

MD. Resident Physician, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

Eun Jung Kim, Kosin University College of Medicine

MD. Resident Physician, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

Ho Sik Shin, Kosin University College of Medicine

MD. Assistant Professor, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea

Yeon Soon Jung, Kosin University College of Medicine

MD, PhD. Associate Professor, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea

Hark Rim, Kosin University College of Medicine

MD, PhD. Professor, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea

References

Whalen RK, Althausen AF, Daniels GH. Extra-adrenal pheochromocytoma. J Urol. 1992;147(1):1-10.

Gifford RW Jr, Manger WM, Bravo EL. Pheochromocytoma. Endocrinol Metab Clin North Am. 1994;23(2):387-404.

Thompson LD. Pheochromocytoma of the Adrenal gland Scaled Score (PASS) to separate benign from malignant neoplasm: a clinicopathologic and immunophenotypic study of 100 cases. Am J Surg Pathol. 2002;26(5):551-66.

Pacak K, Linehan WM, Eisenhofer G, Walther MM, Goldstein DS. Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann Intern Med. 2001;134(4):315-29.

Bourne RB, Beltaos E. Pheochromocytoma of the bladder: case report and summary of literature. J Urol. 1967;98(3):361-4.

Fraley SE, Smith CL. Unusual location of pheochromocytoma in the urinary bladder. J Urol. 1959;81(1):130-2.

Kappers MH, van den Meiracker AH, Alwani RA, Kats E, Baggen MG. Paraganglioma of the urinary bladder. Neth J Med. 2008;66(4):163-5.

Tazi MF, Ahallal Y, Tazi E, et al. Pheochromocytoma of the urinary bladder: a case report. Cases J. 2009;2:8585.

Seki N, Mukai S, Gamachi A, et al. A case of bladder pheochromocytoma. Urol Int. 2001;66(1):57-60.

Day JW, Raskin NH. Thunderclap headache: symptom of unruptured cerebral aneurysm. Lancet. 1986;2(8518):1247-8.

Schwedt TJ. Clinical spectrum of thunderclap headache. Expert Rev Neurother. 2007;7(9):1135-44.

Schwedt TJ, Matharu MS, Dodick DW. Thunderclap headache. Lancet Neurol. 2006;5(7):621-31.

Goldfarb DA, Novick AC, Bravo EL, et al. Experience with extra-adrenal pheochromocytoma. J Urol. 1989;142(4):931-6.

Huang KH, Ching SD, Chen SC, et al. Clinical and pathological data of 10 malignant pheochromocytomas: long-term follow up in a single institute. Int J Urol. 2007;14(3):181-5.

Sung KT, Lee SK, Yoon JB. Pheochromocytoma of the urinary bladder. Korean J Urol. 1991;32(5):829-35. Available from: http://koreamed.org/SearchBasic.php?RID=1020KJU%2F1991.32.5.829&DT=1&QY=%22Korean+J+Urol%22+%5BJTI%5D++AND+32+%5BVO%5D+AND+5+%5BISSU%5D. Accessed in 2013 (Oct 25).

Celiktas M, Okur N, Aikimbaev KS, et al. Bladder pheochromo-cytoma encountered on sonography. Australas Radiol. 2004; 48(3):398-400.

Fujishima S, Abe I, Kaseda S, et al. Ambulatory blood pressure monitoring in diagnosing a pheochromocytoma of the urinary bladder. A case report. Angiology. 1997;48(7):655-8.

Doran F, Varinli S, Bayazit Y, Bal N, Ozdemir S. Pheochromocytoma of the urinary bladder. APMIS. 2002;110(10):733-6.

Ram CV, Engelman K. Pheochromocytoma--recognition and management. Curr Probl Cardiol. 1979;4(1):1-37.

Attyaoui F, Nouira Y, Kbaier I, Ben Younes A, Horchani A. Le phéochromocytome vésical [Bladder pheochromocytoma]. Prog Urole. 2000;10(1):95-8.

Michel F, Gattegno B, Sicard JF, Roland J, Thibault P. A propos d’une observation de phéochromocytome vésical malin: conduite diagnostique et thérapeutique. Ann Urol 1990;24(5):396-9. Available from: http://cat.inist.fr/?aModele=afficheN&cpsidt=19306983. Accessed in 2013 (Oct 25).

Downloads

Published

2015-03-03

How to Cite

1.
Han YJ, Ock SY, Kim EJ, Shin HS, Jung YS, Rim H. Thunderclap-like headache triggered by micturition and angina as an initial manifestation of bladder pheochromocytoma: a case report. Sao Paulo Med J [Internet]. 2015 Mar. 3 [cited 2025 Oct. 15];133(2):154-9. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1046

Issue

Section

Case Report