title: Complete Remission in Metastatic Pheochromocytoma Treated with Extensive Surgery.
abstract: Pheochromocytomas are rare neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla. Malignant pheochromocytoma is defined as the presence of metastatic spread in tissues where chromaffin cells are not usually present. This case report describes the case of a relapsed malignant pheochromocytoma, spread to the right liver lobe, superior pole of the right kidney, posterior right hemidiaphragm, right hemidiaphragmatic pillar, inferior vena cava, and regional lymph nodes. After evaluation, an extensive surgery was performed, with resection of all the affected tissues and regional lymphadenectomy. No adjuvant treatment (radiotherapy or chemotherapy) was given. Complete clinical, biochemical, and radiological remission was achieved, with normalisation of metanephrine and normetanephrine. To date, six years after surgery, the patient remains asymptomatic and normotensive without taking any antihypertensive medication. We conclude that the therapeutic approach should be individualized in the case of metastatic pheochromocytoma. Extensive surgery can be considered as a treatment option, even in the case of multiple metastases, as it may be able to achieve complete remission of the disease, avoiding costly and potentially dangerous adjuvant therapies.
authors.affiliation: Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín.
authors.forename: Claudia
authors.initials: C
authors.lastname: Arnas-Leon
authors.affiliation: Radiology, Hospital Universitario de Gran Canaria Doctor Negrín.
authors.forename: Víctor
authors.initials: V
authors.lastname: Sánchez
authors.affiliation: Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín.
authors.forename: Ana D
authors.initials: AD
authors.lastname: Santana Suárez
authors.affiliation: Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín.
authors.forename: Sara
authors.initials: S
authors.lastname: Quintana Arroyo
authors.affiliation: Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín.
authors.forename: Carmen
authors.initials: C
authors.lastname: Acosta
authors.affiliation: Endocrinology, Clinica San Roque.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Martinez Martin
keywords: catecholamines; extensive surgery; malignant pheochromocytoma; metanephrines; metastatic pheochromocytoma; normetanephrines; pheochromocytoma