Text/Yangcheng Evening News All-Media Reporter Liu Xinyu
Correspondent Xu Yongyi
Photo/Provided by the hospital
Wu Bo (pseudonym), who is in his 50s, has blood pressure in recent years It is getting higher and higher, the highest can even reach 200/120mmHg, and it is still not well controlled after using four antihypertensive drugs. Hypertension is often referred to as the “invisible killer” because the vast majority of patients like Woober have no symptoms at all.
However, until this year, Wu Bo couldn’t sit still anymore, and the skin all over his body began to grow a lot of small bumps, like tree bark. Recently, he came to the outpatient clinic of Professor Wu Wenqi, deputy director of the Department of Urology of the Second Affiliated Hospital of Guangzhou Medical University. Unexpectedly, he found out a rare disease – neurofibromatosis combined with adrenal pheochromocytoma!
Skin “bark-like” changes
palpitation and chest tightness, actually caused by tumors
< p>Wu Wenqi inquired about Wu Bo’s medical history in detail, and found that Wu Bo’s blood pressure was characterized by paroxysmal rise, his blood pressure fluctuated easily, and occasionally had symptoms of heart palpitations and profuse sweating, as well as pigmentation spots and small pimples on Wu Bo’s skin. , reminded Wu Wenqi of a rare disease – neurofibromatosis combined with adrenal pheochromocytoma!
In order to further clarify the condition, Wu Wenqi suggested Wu Bo to be admitted to the hospital. After CT examination, it was found that his bilateral adrenal glands had tumors! The tumor on the left is about 5cm and on the right is 3cm. Blood tests showed elevated blood catecholamines such as norepinephrine and epinephrine, which contribute to high blood pressure.
The left and right adrenal masses found by CT examination
after the skin of Guangzhou Second Hospital After multi-disciplinary consultations such as department, endocrinology, cardiovascular department, critical care medicine department, imaging department, and anesthesiology department, Wu Wenqi’s previous judgment was confirmed: the possibility of neurofibromatosis type I combined with adrenal pheochromocytoma is high! In response to the high blood pressure caused by this disease, the doctor gave Wu Bo a drug called α-receptor blocker, and the blood pressure could be controlled at the normal level of 110-120/70-80mmHg.
Complete resection of the tumor and stable blood pressure recovery
After further improvement of relevant examinations, as well as adequate preoperative volume expansion, cardiovascular and other preparations, under the guidance of Zhou Xing, director of the urology department of the hospital Next, a urology team composed of experts such as Zhang Lichao, Wu Wenqi, Deng Zhennong and others performed 3D laparoscopic left adrenal tumor resection on Wu Bo.
Woober’s left adrenal mass was successfully removed by surgery
Although the patient’s blood pressure was as high as 240mmHg during surgery However, with the close cooperation of the anesthesia and surgical nursing team, the tumor was successfully removed completely during the operation, and the postoperative pathology report showed that it was a pheochromocytoma. After the operation, Wuber’s blood pressure was finally controlled smoothly within the normal range of 120-140/80-90mmHg.
Professor Wu Wenqi introduced that neurofibromatosis is a rare autosomal dominant genetic disease, and its skin lesions are characterized by pigmented macules and multiple neurofibromas. It is currently believed that only 0.1%-5.7% of patients with neurofibromatosis type I have a pheochromocytoma, and bilateral pheochromocytoma is even rarer.
At the same time, Professor Wu Wenqi reminded that in general, Wu Bo is indeed a special and rare situation. However, even without this “bark-like” skin change, if we encounter it in real life. In the case of repeated hypertension and poor drug control, attention should also be paid, especially the possibility of adrenal disease. Go to a regular hospital for treatment in time, identify the cause, and treat it as soon as possible to avoid adverse consequences such as cardiovascular and cerebrovascular accidents caused by long-term hypertension.
Know our blood pressure!
The World Health Organization and the International Federation of Cardiology Societies have designated May 17 every year as “World Hypertension Day”, in order to hope that more people will pay attention to and know about our own blood pressure, but In fact, many patients do not know they have high blood pressure and therefore do not receive timely treatment.
Figure/Visual China
The only way to diagnose high blood pressure is to measure blood pressure. All adults should have their blood pressure measured regularly, ideally every time they visit a health care facility. How to accurately measure blood pressure? The World Health Organization gives the following 8 points of attention:
1. Do not speak when measuring blood pressure;
2. Have arms supported and raise them to the height of the heart;
3. Expose the upper arm and fasten it with a cuff;
4. Use the appropriate size cuff;
5. The feet should be flat on the ground;
< p>6. Do not cross your legs;
7. Empty urine before measuring blood pressure;
8. Choose a chair with a backrest, with the back close to the backrest.