Transcatheter arterial embolization for the treatment of liver metastases in a patient with malignant pheochromocytoma.
A 63-year-old male patient was admitted for the treatment of malignant pheochromocytoma with multiple liver metastases. Plasma and urinary levels of catecholamines were elevated. Transcatheter arterial embolization (TAE) with concomitant administration of mitomycin C and gelatin sponge was performed for the treatment of liver metastases. Dose of alpha-1 blocker before TAE was increased to prevent hypertensive crisis during and after TAE. The hepatic metastatic lesion of CT findings was decreased after TAE. Although blood pressure showed a transient hypertension (180/100 mmHg) after every TAE, it returned rapidly to normal. The patient experienced transient abdominal pain, nausea, and loss of appetite after every TAE; however, those symptoms were readily controlled by conventional medications. Slight elevation of liver transaminases was recognized but returned to normal range within 3 weeks. No other major side effects were seen with TAE. While plasma and urinary level of catecholamines were unchanged, plasma chromogranin A (CgA) level was significantly decreased. These results suggest that TAE is a useful treatment for hepatic metastases. Plasma CgA level is a useful marker in the treatment of malignant pheochromocytoma.
Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical University, Japan.
Daisuke
D
Watanabe
Akiyo
A
Tanabe
Mitsuhide
M
Naruse
Mika
M
Tsuiki
Nobuyuki
N
Torii
Takao
T
Noshiro
Kazue
K
Takano
D000310:Adrenal Gland Neoplasms / Q000473:pathology* / Q000601:surgery; D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology; D000792:Angiography; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002395:Catecholamines / Q000097:blood / Q000652:urine; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood; D004621:Embolization, Therapeutic / Q000379:methods*; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D010673:Pheochromocytoma / Q000556:secondary* / Q000628:therapy*
D000317:Adrenergic alpha-Antagonists; D000903:Antibiotics, Antineoplastic; D002395:Catecholamines; D053379:Chromogranin A; D002864:Chromogranins; D016685:Mitomycin