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4th March 2024
A 24-year-old male presents with treatment-resistant hypertension. He reports having episodic headaches
A 24-year-old male presents with treatment-resistant hypertension. He reports having episodic headaches for the past three weeks accompanied by panic attacks, sweats and palpitations. These come on without a clear trigger and would settle without any intervention. Observations show a blood pressure of 148/70mmHg. The cardiovascular examination was unremarkable. Examination of the patient’s neck reveals a solid lump that moves with swallowing but not on tongue protrusion. Blood test results were as follows:
| Test | Value | Normal range |
|---|---|---|
| Corrected calcium | 2.82 | 2.2-2.6 mmol/L |
| PTH | 98 | 10-55 pg/ml |
| Calcitonin | 35 | <10ng/L |
| 24-hour urinary metanephrine | 5.4 | <1.3μmol/24hour |
What is the likely underlying diagnosis for this patient?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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