title: Perioperative, functional, and oncologic outcomes of partial adrenalectomy for multiple ipsilateral pheochromocytomas.
abstract: OBJECTIVE
  Managing patients with multiple adrenal masses is technically challenging. We present our experience with minimally invasive partial adrenalectomy (PA) performed for synchronous multiple ipsilateral pheochromocytomas in a single setting.
  
  
  METHODS
  We reviewed records of patients undergoing PA for pheochromocytoma at the National Cancer Institute between 1994 and 2010. Patients were included if multiple tumors were excised from the ipsilateral adrenal gland in the same operative setting. Perioperative, functional, and oncologic outcomes of PA for multiple pheochromocytomas are shown.
  
  
  RESULTS
  Of 121 partial adrenalectomies performed, 10 procedures performed in eight patients for synchronous multiple ipsilateral pheochromocytomas were identified. All eight patients were symptomatic at presentation. The mean patient age was 30.6 years, median follow up was 12 months. The average surgical time was 228 minutes, average blood loss of 125 mL, and average number of tumors removed was 2.6 per adrenal. In total, 26 tumors were removed, 24 were pathologically confirmed pheochromocytomas, while two were adrenal cortical hyperplasia. After surgery, all patients had resolution of their symptoms, one patient required steroid replacement postoperatively. On postoperative imaging, one patient had evidence of ipsilateral adrenal nodule at the prior resection site 2 months postoperatively, which was consistent with incomplete resection.
  
  
  CONCLUSIONS
  Minimally invasive surgical resection of synchronous multiple pheochromocytomas is feasible with acceptable perioperative, functional, and short-term oncologic outcomes.
authors.affiliation: 1 Department of Urology, Loyola University Medical Center , Maywood, Illinois.
authors.forename: Gopal N
authors.initials: GN
authors.lastname: Gupta
authors.forename: Jonas S
authors.initials: JS
authors.lastname: Benson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ross
authors.forename: Vani S
authors.initials: VS
authors.lastname: Sundaram
authors.forename: Kelly Y
authors.initials: KY
authors.lastname: Lin
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
authors.forename: W Marston
authors.initials: WM
authors.lastname: Linehan
authors.forename: Gennady
authors.initials: G
authors.lastname: Bratslavsky
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000453:epidemiology / Q000601:surgery*; D000311:Adrenal Glands / Q000601:surgery; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D010673:Pheochromocytoma / Q000453:epidemiology / Q000601:surgery*; D011184:Postoperative Period; D055815:Young Adult