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  #1  
Old 09-04-2011
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Question Can you locate this abdominal mass?

A 39-year-old patient is seen in your office for evaluation of an abdominal mass. Last week, the patient was seen in the ER for unresolved abdominal pain and had an abdominal CT. Although you do not have the abdominal CT films present, she did report that an unspecified abdominal mass was imaged. After further questioning, she reports that she has occasional headaches and an anxiety sensation throughout the day. She has no other medical history and does not currently take any medications. On exam, you notice that she has a blood pressure of 163/79 while lying down, and 108/60 while standing. You suspect that the abdominal mass may likely be located in:
A. Adrenal glands
B. Renal
C. Abdominal aorta
D. Liver
E. Intestinal
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Old 09-04-2011
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it should be C i think so
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  #3  
Old 09-04-2011
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The answer is adrenal gland
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Old 09-04-2011
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pheochromocytoma
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Old 09-04-2011
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Quote:
Originally Posted by yasirsattar75 View Post
it should be C i think so
why is it C? i think its pheochrocytoma and the ans is adrenal gland!
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  #6  
Old 09-04-2011
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Its Adrenal Gland.
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Old 09-05-2011
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adrenal glands
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Old 09-05-2011
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yeah A. adrenal gland is the only thing that makes sense
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Old 09-05-2011
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a.adrenal gland
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Old 09-05-2011
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My bet would be adrenal based on mass/anxiety,headaches...
But why does pressure changes with posture?
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Quote:
Originally Posted by DocSikorski View Post
My bet would be adrenal based on mass/anxiety,headaches...
But why does pressure changes with posture?
that's interesting point, because of high cathechoamines in circulations ,receptors have became desenstisized so when changing posture, vasoconstricure doesnt happen and bp drops.
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Old 09-05-2011
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Adrenal


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Old 09-05-2011
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Interesting, it suggest a Pheochromocytoma in the adrenal mass, but the change of bp on Posture suggest for me Abdominal Aorta.
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Old 09-05-2011
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A.adrenal glands
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Old 09-05-2011
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Quote:
Originally Posted by rulz View Post
Interesting, it suggest a Pheochromocytoma in the adrenal mass, but the change of bp on Posture suggest for me Abdominal Aorta.
yeah i was also thinking of abdomial aorta but just studied at wikipedia that in pheopcromocytoma orthostatic hypotension can be present by 10 to 20mmhg decrease in b.p source ...
http://en.wikipedia.org/wiki/Pheochr...tial_diagnosis
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Old 09-08-2011
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The correct answer is A.
The description of paroxysmal headaches and anxiety with a history of hypertension and orthostatic hypotension in the context of an abdominal mass is concerning for a pheochromocytoma. Pheochromocytomas are neuroendocrine tumors which commonly originate in the medulla of adrenal gland
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