Polycythemia secondary to pheochromocytoma
John D. Battle, M.D.
Department of Hematology
Ralph J. Alfidi, M.D.
Division of Radiology
Ralph A. Straffon, M.D.
Department of Urology
POLYCYTHEMIA is uncommon in patients with pheochromocytoma. Waldmann and Bradley1 reported the case of a 10-year-old boy with profound polycythemia that was corrected by surgical extirpation of bilateral pheochro-mocytoma. The patient also had associated hypertension and increased urinary excretion of catecholamine. Erythropoietic-stimulating factor was demonstrated in the tumor.
Our report concerns a normotensive woman with polycythemia, in whom an unsuspected pheochromocytoma was discovered by means of arteriography. After surgical removal of the tumor, polycythemia regressed.
Report of a case
A 41-year-old woman was admitted to a hospital on December 29, 1968, because of gastrointestinal upset. At that time, she had a ruddy complexion; the blood hemoglobin value was 19.6 g per 100 ml, and the hematocrit 65 percent. She was not cyanotic. The leukocyte count was 4200 per cubic millimeter, with normal differential count; the platelet count was 365,000 per cubic millimeter. The reticulocyte count was 1 percent. The patient had no symptoms of bath pruritis or shortness of breath. The spleen was not palpable. A pelvic examination disclosed evidence suggestive of uterine fibroids. After several venesections hysterectomy was performed on January 17, 1969. The uterus weighed 170 g, and contained several small fibroids. The possibility of familial erythrocytosis was excluded by examinations of the siblings and other members of the family. In April 1969 the patient was referred to the Cleveland Clinic because of polycythemia of unknown etiology. The blood pressure was 135/76 mm Hg, and the pulse rate 80 and regular. The skin and mucous membranes revealed mild . . .