Journal of Endocrinological Investigation

, Volume 28, Issue 4, pp 175–179 | Cite as

Intrahepatic cholestasis as a paraneoplastic syndrome associated with pheochromocytoma

  • C. H. Chung
  • C. H. Wang
  • C. Y. Tzen
  • C. P. LiuEmail author
Case Report


Pheochromocytoma is a rare tumor of chromaffin cells that secrete catecholamines and several cytokines. The clinical manifestations are protean and may include hypertension, weight loss, sweating, palpitation, headache, anxiety, tremor, nausea, vomiting, and hypercalcemia. The tumor can mimic many unrelated diseases, leading to significant delay and difficulty in diagnosis. We report a case of a 37-yr-old male admitted with jaundice, dark urine, fever, and signs of a systemic inflammatory response. Abdominal computed tomography revealed a heterogeneously enhancing tumor between the pancreatic tail and left kidney. There was no evidence of obstruction to bile flow, neoplastic involvement of the liver or bile ducts, or infectious etiology. The tumor was removed and found to be a pheochromocytoma. Immunohistochemical analysis revealed the presence of interleukin-1β in the tumor cells. After surgery, the jaundice resolved without further treatment, leading us to the conclusion that it was a paraneoplastic phenomenon possibly related to interleukin-1β production. We suggest that occult pheochromocytoma should be added to the differential diagnosis of unexplained intrahepatic cholestasis.


pheochromocytoma cholestasis paraneoplastic syndrome IL-1β fever 


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Copyright information

© Italian Society of Endocrinology (SIE) 2005

Authors and Affiliations

  • C. H. Chung
    • 1
  • C. H. Wang
    • 1
  • C. Y. Tzen
    • 2
  • C. P. Liu
    • 3
    Email author
  1. 1.Division of Endocrinology and Metabolism, Department of MedicineMackay Memorial Hospital, Mackay Medicine, Nursing and Management CollegeTaipeiTaiwan
  2. 2.Department of PathologyMackay Memorial Hospital, Mackay Medicine, Nursing and Management CollegeTaipeiTaiwan
  3. 3.Division of Infectious Diseases, Department of Medicine and Department of Medical ResearchMackay Memorial HospitalTaipeiTaiwan

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