Endocrinology Grand 98.6.4

Endocrinology Grand 98/6/4

Meysam orangi

A 38 y/o man from Ardabil, married/infertile, known case of DM2 & Pheochromocytoma and osteosarcoma with chief complaint of increased blood glucose and left flank mass since 5 month ago

The patients admitted in endocrine ward for better control of blood glucose and w/u of flank mass

In 1383(23 y/o), he presented with left leg bulging and pain and walking debility / bone biopsy show osteosarcoma / for treatment chemotherapy and BMT was done  

In 1389 (29y/o) ,he  presented with high blood pressure(BP),headache,

palpitation, sweating and orthostatic BP change

Lab data was in faver of pheochromocytoma and imaging show bilateral adrenal mass

After 2 month undergo bilateral adrenalectomy and pathology report showed  bilateral pheochromocytoma

After surgery , the patient had not hypertension and orthostatic change

and was well until 5 month ago that he complaint of weakness , decrease

BP and orthostatic change and left flank mass

In 1390 ( 1 year after surgery ) suffering from recurrent episode of gout artheropathy and lab data show renal failure.

He affected to diabetes mellitus in 1394 (34y/o) and was control with oral agent (metformin) until 5 month ago that insulin begin but blood glucose not controlled in time

Within recent 5 month had multiple complaint of headache(frontal) blurred vision, hearing loss and occasional epistaxis , diarrhea (occasionally bloody) and fever(unknown origin)     colonoscopy……internal hemorrhoid/2 polyp(inflammatory hyperplastic)

Negative Hx of abdominal pain and weight loss

In current admission, he had 3 times of epistaxis and ENT consult was done.