An Atypical Manifestation of Pheochromocytoma Crisis: Acute Delirium

Pheochromocytoma is a rare neuroendocrine tumor presenting with classical triad of symptoms. In 10% the cases presentation can be atypical, and diagnosis often missed for several years. Most common neurological manifestations are haemorrhage, seizures, etc., but pheochromocytoma crisis as delirium has been infrequently reported. We present case middle-aged female who presented hypertensive emergency acute confusional state. Other causes were ruled out in patient timely was made CT abdomen showed large right suprarenal mass which confirmed on 123I-MIBG scan supported by elevated plasma metanephrines. She responded to alpha beta blockers following her blood pressure spikes controlled subsequently sensorium improved significantly. Patient underwent surgical resection followed up after 2 weeks without any medications.