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DOI:10.2214/AJR.06.5028.1
AJR 2006; 186:1201
© American Roentgen Ray Society

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Michael A. Blake

Massachusetts General Hospital and Harvard Medical School Boston, MA

Ann T. Sweeney

St. Elizabeth's Medical Center and Tufts University School of Medicine Boston, MA

Michael M. Maher and Peter R. Mueller

Massachusetts General Hospital and Harvard Medical School Boston, MA

We thank Drs. Kashyap, Anand, and Kashyap for their letter highlighting the correct way to treat a patient with a known pheochromocytoma to avoid or treat a crisis. However, in the case discussed in our article [1], the final diagnosis of pheochromocytoma was only made with subsequent pathology. Indeed, when cardiology was consulted, the cause was still unclear. Although pheochromocytoma was considered, it was decided that given the patent's advanced age, congestive heart failure, and low ejection fraction, along with his relatively mild hypertension and tachycardia, to give a conservative (25 mg) metoprolol dose to which the patient fortunately responded.

Nonetheless, we agree completely with the correspondents' comments regarding standard treatment of patients with pheochromocytomas. Finally, we would like to emphasize that the letter was written to highlight that biopsy of an unsuspected pheochromocytoma can occur and that we avoided full discussion of treatment in this letter due to space constraints.


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  1. Dalal T Maher MM, Mueller PR. Extraadrenal pheochromocytoma: a rare cause of tachycardia and hypertension during percutaneous biopsy. AJR 2005; 185:554 -555[Free Full Text]

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This Article
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