Introduction: A pheochromocytoma is a rare catecholamine secreting neuroendocrine tumor, originating within the adrenal medulla. Most cases present with a hypertensive crisis and a classic triad of headaches, sweating, and palpitations. A positive prognosis is projected for patients after operative removal of the tumor. Early detection of this tumor is crucial as it can be fatal if left untreated. Clinical signs and symptoms, diagnostic criteria, and imaging appearances are described to assist in this case of a pheochromocytoma, detected in a pediatric patient.Early detection and intervention are critical to avoid severe cardiovascular complications.

Case Presentation: We present the case of a 11-year-old girl who exhibited episodes of severe headaches, palpitation, sweating, giddiness, blurring of vision and paroxysmal hypertension. similar complain in the mother at 19 yrs of age for which she had undergone adrenalectomy, child had normal physical and general examination. As the child hypertensive emergency for which she was on multiple antihypertensives. Initial laboratory tests were normal. Abdominal ultrasound and cect identified a 3.5 cm bilateral adrenal mass. which was later confirmed by FDG PET SCAN. Following a comprehensive preoperative assessment, including alpha-adrenergic blockade to stabilize blood pressure, the patient underwent successful bilateral laparoscopic adrenalectomy with left nephrectomy. Histopathological analysis confirmed the diagnosis of pheochromocytoma. Postoperative follow-up showed complete resolution of symptoms and normalization of blood pressure without the need for antihypertensive therapy.

Discussion: This case highlights the clinical presentation of pheochromocytoma in a pediatric patient with autosomal dominant pattern, emphasizing the importance of considering this diagnosis in children with unexplained hypertension and characteristic symptoms. The diagnostic process, including biochemical testing and advanced imaging, is essential for accurate diagnosis. Preoperative management with alpha-blockade is critical for minimizing intraoperative complications. Surgical removal is the definitive treatment and typically results in the resolution of symptoms and hypertension.

Conclusion: Pediatric pheochromocytoma, while rare, should be considered in the differential diagnosis of pediatric hypertension. Correlating the sonographic identification and classic triad of symptoms (headaches, sweating, and palpitations) can assist the clinical team in further patient management. Early recognition, meticulous diagnostic work-up, and appropriate surgical intervention are vital for favorable outcomes. This case reinforces the need for heightened clinical awareness and a multidisciplinary approach to management.