title: A case of giant malignant phaeochromocytoma.
abstract: Malignant phaeochromocytoma is defined as the presence of tumour deposits at sites that are normally devoid of chromaffin cells. We report on a 63-year-old man who had a giant malignant phaeochromocytoma of the right adrenal gland that encased the inferior vena cava. The urinary excretion rates of catecholamines and their metabolites were normal, except for normetanephrine, which was excreted at a higher rate than normal. The tumour was surgically unresectable by laparotomy. Postoperatively, the patient was given a 4-month trial of subcutaneous octreotide and intravenous meta-iodobenzylguanidine I 131. Occult lung secondary tumours were first detected by meta-iodobenzylguanidine scintigraphy after 2 years, and the patient died of bone and lung metastases 1 year later. Because phaeochromocytoma is rare, local experience in managing this disease is limited. This report alerts physicians of the methods of diagnosing and managing surgically unresectable malignant phaeochromocytoma.
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: F K
authors.initials: FK
authors.lastname: Chan
authors.forename: K L
authors.initials: KL
authors.lastname: Choi
authors.forename: S C
authors.initials: SC
authors.lastname: Tiu
authors.forename: C C
authors.initials: CC
authors.lastname: Shek
authors.forename: T K
authors.initials: TK
authors.lastname: Au Yong
mesh_terms: D019797:3-Iodobenzylguanidine / Q000627:therapeutic use*; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009647:Normetanephrine / Q000652:urine; D015282:Octreotide / Q000627:therapeutic use*; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D019275:Radiopharmaceuticals; D009647:Normetanephrine; D019797:3-Iodobenzylguanidine; D015282:Octreotide