Pseudopheochromocytoma in the Conflict Zone of Northwest Syria: A Case Report and Literature Review

Background: Pseudopheochromocytoma is a rare clinical entity characterized by symptoms resembling those of pheochromocytoma, despite the absence of an adrenal medullary tumor. Its diagnosis remains difficult due to overlapping features with various other conditions and the absence of definitive diagnostic markers.Methods: We report the case of a 47-year-old male school teacher who developed pseudopheochromocytoma, likely precipitated by psychological stress associated with prolonged exposure to the war-torn environment of Northwest Syria.Results: The patient presented with repeated episodes of sudden-onset severe hypertension, along with palpitations, excessive sweating, headaches, chest discomfort, and facial flushing. A comprehensive workup ruled out endocrine and structural causes. The psychological burden linked to displacement and chronic instability was believed to be a significant contributing factor. Given the patient’s asthma, beta-blockers were avoided. Management with the calcium channel blocker (Diltiazem) and the antidepressant (Sertraline) resulted in substantial clinical improvement.Conclusion: Pseudopheochromocytoma can closely imitate true pheochromocytoma, making careful evaluation essential. In selected cases, calcium channel blockers combined with antidepressant therapy may offer effective symptom control. More studies are needed to establish standardized treatment strategies for this underrecognized condition.Keywords: Hypertension; Pheochromocytoma; Pseudopheochromocytoma; Syria; Conflict