A Case of Undiagnosed Pheochromocytoma Caused by Negative Metoclopramide Test

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  • Metoclopramide投与試験が陰性で診断に難渋した褐色細胞腫の一例

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Metoclopramide (MCP), a dopamine antagonist, was recently used as the pharmacological test for the diagnosis of pheochromocytoma. There have been no reports involving false negative cases in the MCP test. We experienced a rare case of pheochromocytoma which showed a negative MCP test, and it caused a failure of the diagnosis.<BR>A 51 -year-old man visited our hospital with a sudden onset of headache and palpitation. Blood pressure was 218/98mmHg at another hospital. When he came to our hospital, blood pressure returned to normal (120/80mmHg), and both serum adrenaline (E) and noradrenaline (NE) were within normal limits. A computed tomography, magnetic resonance imaging, and angiography demonstrated a 1.8×1.8cm right adrenal mass. No changes in blood pressure and plasma catecholamine were observed following the injection of 10mg of MCP.<BR>The pathologically resected right adrenal gland contained a typical pheochromocytoma which was 1.0×1.0cm in size and weighed 8g.<BR>The detailed mechanism of the negative MCP test in this case was not known but might be related to the small size of the tumor.

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