Adrenal Pheochromocytoma Producing Vasoactive Intestinal Peptide and Masking Hypertension

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AIM: To report a case of a pheochromocytoma secreting vasoactive intestinal peptide (VIP). METHODS: We studied a 77-year-old woman who had suffered from persistent diarrhea and episodes of sweating and palpitations. RESULTS: She had neither previous or current anamnesis of hypertension nor any known familial dispositions to endocrine diseases. Initially gastrointestinal investigations were carried out based on longstanding diarrhea with hypopotassemia, but radiological imaging revealed a unilateral adrenal mass. Biochemical testing showed increased levels of catecholamine and VIP, and (123)I-metaiodobenzylguanidine scintigraphy confirmed the adrenal origin as well as the diagnosis of a VIP-producing pheochromocytoma. The patient underwent surgical removal of the tumor which led to relief of symptoms and normalized laboratory values. CONCLUSION: This case report focuses on the protean mode of presentation seen in pheochromocytomas as well as their capacity to produce several neuropeptides, ultimately intensifying the need for early examination for this condition despite unrelated symptoms.

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