A case of massive adrenal malignant pheochromocytoma: management of a large pheochromocytoma.
A 69-year-old man was referred to our hospital for a left abdominal tumor measuring about 30 cm in diameter. Laboratory examination revealed an elevation of norepinephrine in plasma and of its metabolites in urine. CT scan disclosed a huge cystic tumor in the retroperitoneal space and an enlarged aortocaval lymph node, suggesting a diagnosis of malignant pheochromocytoma. The hemodynamic studies showed low blood volume and high vascular resistance, and therefore, he was treated with vasodilators and volume expansion. His hemodynamic status normalized and a complete excision was performed. Pathological examination revealed that the patient had a pheochromocytoma with metastasis to a lymph node. The total weight of the tumor was 5,930 g. Since pheochromocytomas can become a large with a risk of malignancy, they should be surgically excised as completely as possible with further treatment after making a definite diagnosis.
D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D001810:Blood Volume; D006439:Hemodynamics; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D010673:Pheochromocytoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014655:Vascular Resistance