Following an acute spontaneous hypertensive crisis and shock a patient with pheochromocytoma was found to have an exceedingly high catecholamine excretion rate. After this episode, the patient remained normotensive and urinary excretion of catecholamines returned to normal. During surgery, a large pheochromocytoma was found and removed that showed avascular necrosis.
In pheochromocytoma, a sudden and exceedingly high rate of catecholamine release may cause intense vasoconstriction both generally and within the tumor itself. In this patient, avascular tumor necrosis led to a spontaneous remission of clinical symptoms.
(Arch Intern Med 137:1073-1075, 1977)
Atuk NO, Teja K, Mondzelewski JP, Turner SM, Selden RF. Avascular Necrosis of Pheochromocytoma Followed by Spontaneous Remission. Arch Intern Med. 1977;137(8):1073-1075. doi:10.1001/archinte.1977.03630200075020