A 16-Year-Old Boy with Headache, Abdominal Pain, and Hypertension

This case report details the clinical journey of a 16-year-old boy presenting with headache, abdominal pain, and hypertensive emergency following a history of post-traumatic headache. Initial workup revealed extreme hypertension (239/162 mm Hg), elevated troponin, leukocytosis, acute kidney injury, and left ventricular hypertrophy. Subsequent imaging uncovered a large hemorrhagic right adrenal mass, and laboratory results showed markedly elevated plasma and urinary metanephrines, catecholamines, and vanillylmandelic acid. The diagnosis of pheochromocytoma was confirmed. After stabilization with alpha-blockade (phenoxybenzamine) and cautious beta-blockade, the tumor was successfully resected. Histopathology showed classic zellballen architecture and chromogranin positivity. 

This case report details the clinical journey of a 16-year-old boy presenting with headache, abdominal pain, and hypertensive emergency following a history of post-traumatic headache. Initial workup revealed extreme hypertension (239/162 mm Hg), elevated troponin, leukocytosis, acute kidney injury, and left ventricular hypertrophy. Subsequent imaging uncovered a large hemorrhagic right adrenal mass, and laboratory results showed markedly elevated plasma and urinary metanephrines, catecholamines, and vanillylmandelic acid. The diagnosis of pheochromocytoma was confirmed. After stabilization with alpha-blockade (phenoxybenzamine) and cautious beta-blockade, the tumor was successfully resected. Histopathology showed classic zellballen architecture and chromogranin positivity.