TY - JOUR T1 - Pheochromocytoma diagnosed after anticoagulation for atrial fibrillation ablation procedure: A giant in disguise JO - Revista Portuguesa de Cardiologia T2 - AU - Galvão Braga,Carlos AU - Ribeiro,Sílvia AU - Martins,Juliana AU - Arantes,Carina AU - Ramos,Vítor AU - Primo,João AU - Magalhães,Sónia AU - Correia,Adelino SN - 08702551 M3 - 10.1016/j.repc.2013.11.008 DO - 10.1016/j.repc.2013.11.008 UR - https://www.revportcardiol.org/pt-pheochromocytoma-diagnosed-after-anticoagulation-for-articulo-S087025511400078X AB - Pheochromocytoma is a rare catecholamine-producing tumor, discovered incidentally in 50% of cases. We present the case of a 44-year-old male with a history of paroxysmal palpitations. Baseline ECG, transthoracic echocardiogram and ECG stress test showed no relevant alterations. Paroxysmal atrial fibrillation was detected on 24-hour Holter ECG. After antiarrhythmic therapy, the patient remained symptomatic, and was accordingly referred for electrophysiological study and atrial fibrillation ablation. Anticoagulation was initiated before the procedure. After ablation and still anticoagulated, he complained of hematospermia. The abdominal and pelvic imaging study showed a 10-cm left adrenal mass, predominantly cystic, compatible with pheochromocytoma, which was confirmed after biochemical tests (increased urine metanephrines and plasma catecholamines). Metaiodobenzylguanidine scintigraphy scanning confirmed localized disease in the adrenal gland, excluding other uptake foci. Following appropriate preoperative management, surgical resection of the giant mass was performed successfully and without complications. ER -