A pheochromocytoma presenting as generalized pigmentation
Notice bibliographique
Résumé
A 25‐year‐old man presented with pigmentation over the face and hands of 6 months’ duration, which darkened on sun exposure. Four weeks after the onset of pigmentation, he experienced intermittent episodes of excessive sweating, tremors, fatiguability, and headache, which had gradually increased in frequency over the last 5 months. There was a history of anorexia and weight loss of 7 kg over the last 6 months. There was no history of previous drug ingestion, chemical exposure, or any major illness. The family history, including diabetes, tuberculosis, hypertension, endocrine tumors, and pigmentation, was negative. On dermatologic examination, slate‐gray macular pigmentation was noticed on the forehead, cheeks, nose, lips ( Fig. 1 ), helices of the ears, and dorsum of the hands, with prominence over the knuckles and the skin over the interphalangeal joints, elbows, and knees ( Fig. 2 ). Slate‐gray pigmentation on the forehead, cheeks, nose, and lips image Slate‐gray pigmentation on the dorsum of the hands, knuckles, and skin over the interphalangeal joints image The scars of acne and previous injuries over the legs were also hyperpigmented. The mucosa of the hard palate showed streaky linear pigmentation in the midline. On general examination, tachycardia was a constant feature at all visits, and more marked on the last three visits (104, 100, and 120/min, respectively). Hypertension was noted in the right upper arm in the supine position at two of the last three consultations (140/100, 120/84, and 180/118 mmHg, respectively). A significant orthostatic hypotension was noted on standing during the last visit, i.e. 150/110 mmHg. The following laboratory investigations were performed: hemoglobin (Hb), 11.7 g%; erythrocyte sedimentation rate (ESR), 30 mm in the first hour; serum cortisol, 26.8 mg/dL (N < 14 mg/dL, PM sample); serum adrenocorticotrophic hormone (ACTH), 101 pg/mL (N < 60 pg/mL); urinary vanillylmandelic acid (VMA), 16.3 mg in 24 h (N < 9 mg/24 h). The following were all within normal limits: complete blood count (CBC), blood sugar, urinalysis, serum electrolytes, calcium, B‐12 levels, thyroid and liver function tests, and stool (routine and occult blood) test. Chest X‐ray, thyroid scan, and ultrasonography were normal. Human immunodeficiency virus (HIV) was nonreactive. Abdominal sonography revealed a hypoechoic and well‐circumscribed mass in the left suprarenal area. Computed tomography of the abdomen confirmed a tumor location in the left adrenal gland with mild enhancement after contrast ( Fig. 3 ). Ultrasonography depicting tumor location in the left adrenal gland image The patient was operated on to remove a mass measuring 5 cm × 3.5 cm × 3.2 cm. Histopathology of the tissue confirmed a diagnosis of pheochromocytoma. To our surprise, the pigmentation faded rapidly in the immediate postoperative period and the scar at the operation site did not pigment significantly ( Fig. 4 ). Post‐operative fading of pigmentation 6 weeks after surgery image
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».