Takotsubo syndrome induced by pheochromocytoma activation after resection of medullary thyroid carcinoma: a case report

Abstract

Abstract Background Medullary thyroid carcinoma (MTC) and pheochromocytoma are rare neuroendocrine tumors, which are diagnosed simultaneously in approximately 35% of patients. Heart failure and Takotsubo Syndrome (TTS) are rare and life-threatening cardiovascular complications of pheochromocytoma. Case presentation: A 42-year-old woman was admitted to the hospital for surgery because of a thyroid nodule detected on physical examination. After surgery, she presented with acute heart failure in the general ward. The clinical manifestations combined with electrocardiogram, echocardiography, coronary angiography, and myocardial enzyme examination were consistent with the diagnosis of TTS. Postoperative abdominal enhanced CT and catecholamine levels at the time of heart failure supported that acute heart failure and TTS are due to enhanced adrenal pheochromocytoma activity. Conclusions MTC may be complicated with pheochromocytoma. Preoperative examination should be completed. It is recommended to perform pheochromocytoma surgery before MTC resection. In addition, acute heart failure and TTS are rare and serious complications of pheochromocytoma. Further studies are needed on the treatment and pathogenesis of TTS.