A case of massive adrenal malignant pheochromocytoma: management of a large pheochromocytoma
Kondo, T.; Ito, F.; Kihara, T.; Nakamura, R.; Goya, N.; Nakazawa, H.; Toma, H.
Hinyokika Kiyo. Acta Urologica Japonica 41(9): 669-673
1995
ISSN/ISBN: 0018-1994 PMID: 7484530 Document Number: 439679
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.