RECURRENT PAROXYSMAL NECK SWELLINGS AS PR IMARY MANIFESTATION OF A PHEOCHROMOCYTOMA

A 45-year-old female had been suffering for about 6 months almost dail y from paroxysmal neck swellings with occasional difficulties in swall owing and from non-specific abdominal complaints. Hormone analyses, pe rformed because of the marked blood pressure increase up to 210/120 mm Hg during such an attack, revealed an increase in vanillyl mandelic a cid and epinephrine concentrations in the 24-hour urine. CT demonstrat ed a tumour of 4 x 5 x 5 cm size in the region of the right adrenal. T he paroxysmal neck swellings and blood pressure increase could be repr oduced by means of pressure applied over the tumour range with the ult rasound transducer. The tumour was extirpated and histology revealed a phaeochromocytoma. For more than one year now the patient has been fr ee from complaints. - To date, recurrent neck swellings have not been reported in association with a phaeochromocytoma. Possible causes may be an enhanced congestion of the deep neck vessels during paroxysmal b lood pressure increase or an enhanced response by the adrenoreceptors of these vessels to the released catecholamines.