Pheochromocytoma Presenting With Paroxysmal Hypertensive Crises in a Previously Healthy Woman: A Case Report

Pheochromocytomas are rare catecholamine-secreting neuroendocrine tumors that typically present with episodic headaches, sweating, palpitations, and hypertension. Delayed diagnosis, although uncommon, can lead to severe cardiovascular complications. We report the case of a 41-year-old woman with no known comorbidities who presented with a 20-day history of recurrent episodes of severe hypertension, with blood pressure reaching 220/110 mmHg, accompanied by headaches, palpitations, tremor, and diaphoresis. Biochemical evaluation revealed elevated urinary metanephrines and normetanephrines. Abdominal computed tomography (CT) demonstrated a 6-cm left adrenal mass. After appropriate preoperative alpha- and beta-adrenergic blockade, the patient underwent a successful laparoscopic left adrenalectomy. Histopathology confirmed pheochromocytoma. Postoperatively, her blood pressure normalized, antihypertensive therapy was discontinued, and she was advised to undergo genetic testing and regular follow-up. Early recognition of pheochromocytoma is essential, as delayed diagnosis can result in severe and potentially life-threatening complications. This case emphasizes the importance of considering pheochromocytoma in middle-aged patients presenting with unexplained paroxysmal hypertension and adrenergic symptoms, as timely surgical management can be curative.