Pheochromocytoma presenting with headache, panic attacks and jaundice in a child.

Pheochromocytomas can mimic many unrelated diseases due to their various presenting signs; they are encountered very rarely in childhood. Recently, their neuropsychiatric aspects have become a subject of interest for many workers, but most of the findings reported previously have been observed in adults. We present a case report which is unique in that it concerns a child with pheochromocytoma and psychiatric findings consisting of depression and panic disorder, which were interpreted as being directly related to, since they disappeared after the removal of, the tumor. Depression was persistent and accompanied by a constricting-type headache, while panic disorder was acute and accompanied by a migraine-type headache. Another intriguing complication encountered in our case was jaundice; we considered that it could possibly have been due to an adverse effect of catecholamines on hepatocyte function. We conclude that a pheochromocytoma can be confused with neuropsychiatric disorders in children as well as in adults and that it should be considered in the differential diagnosis of such disorders.