Giant Cystic Pheochromocytoma Located in the Renal Hilus

Melegh, Zsombor; Rényi-Vámos, F; Tanyay, Zoltán; Köves, István; Orosz, Zsolt

doi:10.1078/0344-0338-00194

Cited by 19 publications

(18 citation statements)

References 10 publications

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“…The average tumor size is approximately 7 cm, and the average weight is approximately 200 g in the previous publications (2). Sometimes these tumors may be bigger (1,(3)(4)(5)(6)(7)(8). In this report, a case of multicystic malignant pheochromocytoma with a huge size is presented, which is seldom reported in the past.…”

Section: Introductionmentioning

confidence: 81%

“…The average tumor size is approximately 7 cm (2). There are only few reports of huge multicystic malignant pheochromocytoma above 18 cm, and to our knowledge, the pheochromocytoma in this case is the largest one reported from our country (1,(3)(4)(5)(6)(7)(8). Seven giant pheochromocytomas larger than 16 cm in current literature have been documented (Table 1).…”

Section: Discussionmentioning

confidence: 97%

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Giant multicystic malignant pheochromocytoma

et al. 2017

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Pheochromocytoma is a rare tumor originating from the embryonic neural crest and secreting high levels of catecholamines. The average tumor size is approximately 7 cm, and the average weight is approximately 200 g in the previous publications. Sometimes these tumors may be bigger. In this report, a case of multicystic malignant pheochromocytoma with a huge size is presented, which is seldom reported in the past. A 37-year-old male patient was referred to our hospital for etiological investigation of his recently diagnosed hypertension. Contrast-enhanced computed tomography (CT) examination was performed for further evaluation of the lesion and surrounding tissues. The lesion was 18×8×13 cm in size. It had lobulated margins, large cystic components, and peripheral and septal contrast enhancement. The levels of metanephrine, normetanephrine, adrenaline, noradrenaline, vanilmandelic acid, and dopamine were significantly elevated. The patient was prepared for surgery. In the pathological evaluation, the mass weighed 1018 g and was 18×8x13 cm in size. He was diagnosed with malignant pheochromocytoma. After eight months, a CT examination showed a recurrent mass, liver metastasis, and distant metastasis. The patient received chemotherapy and radiotherapy. Multicystic malignant pheochromocytoma may reach huge sizes without causing any symptoms.

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Section: Introductionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 97%

Giant multicystic malignant pheochromocytoma

et al. 2017

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“…Therefore, blocking the effects of released catecholamines are recommended for all patients with biochemically positive PCCs (14). However, in the case of silent PCCs which are not diagnosed until the tumor is further investigated, surgeons may prefer to complete the resection immediately following achieving control over the hypertension during surgery (3,7,10,15,16) compared with postponing the surgery until later (17), despite the evidence that this may result in a hypertensive crisis (3,7), ventricular ectopic rhythms and cardiac arrest (10), or acute myocardial damage as in the present report. When unexpected hypertension occurs during resection of an abdominal tumor, the anesthesiologist and surgeon must consider the diagnosis of pheochromocytoma and clearly realize that it is an anesthetic challenge.…”

Section: Discussionmentioning

confidence: 99%

“…Large adrenal tumors may also cause atrophy of the gland, making the residual gland unrecognizable. Therefore, they are often not accurately diagnosed until the time of resection, when hemodynamic instability occurs, or even following evaluation of pathological specimens (7,(9)(10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

Undiagnosed giant cystic pheochromocytoma: A case report

Wang

Sun

et al. 2015

Oncology Letters

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Abstract. Giant cystic pheochromocytomas (GPCCs) are rare adrenal tumors and the majority of them present as asymptomatic. As a result GPCCs often remain undiagnosed until surgery and therefore the surgical team face a greater challenge in perioperative management. The present study describes the case of a 36 year-old woman with an undiagnosed GPCC, which was successfully resected despite the occurrence of perioperative cardiovascular events, including hypertension, hypotension, ventricular arrhythmias, acute heart failure, acute myocardial infarction, and the patient was discharged home without any recurrence. It should be considered in retroperitoneal tumour of patients with nonspecific symptoms and given adequate treatment to promote the perioperative safety. IntroductionPheochromocytoma (PCC), a rare catecholamine-producing tumor with an estimated incidence of 0.005-0.1% in the worldwide population (1), may result in classical symptoms, including severe hypertension accompanied by headache and palpitation requiring proactive preoperative medical management to decrease morbidity and mortality. However, there are certain exceptions that have been described traditionally as the ̔10% rule̓, as they occur at an incidence of ~10% within patients with PCC (1,2). ̔Silent̓ PCC is one of the exceptions that does not exhibit classic PCC symptoms (3); therefore, ̔silent̓ PCC often remains undiagnosed until surgical excision occurs and the anesthesia teams face a greater challenge. The authors report the case of a silent giant cystic pheochromocytoma (GPCC), which was preoperatively diagnosed as a malignant renal mass; GPCC was confirmed as a result of the classical hypertension crisis following surgical exploration and histopathological evaluation. Case reportWritten informed consent was obtained from the patient and the institutional ethics review board was consulted for approval (not deemed necessary by the Institutional Ethics Review Board of Qilu Hospital, Jinan, China) for publishing this case.A 36-year-old woman presented to Qilu Hospital of Shandong University on May 9, 2013, with the primary complaint of abdominal discomfort following eating and lumbodorsal distending pain for 3 months, and reported weight loss of 8 kg during this time. The patient's medical history included a caesarean section and an ovarian cysts surgery, but no history of hypertension or headache. The patient's vital signs included an arterial blood pressure of 120/80 mmHg, heart rate of 80 bpm and temperature 36.8˚C. The only significant finding during physical examination was for left renal region percussion pain. Laboratory analysis identified a slightly elevated blood glucose level of 7.73 mmol/l (normal range, 3.90-6.10 mmol/l). Ultrasonography examination revealed a cystic space-occupying lesion (10.3x9.3 cm) in the left upper abdomen, which was considered to be a left renal cystic mass. Abdominal computed tomography (CT) and a contrast-enhanced CT scan demonstrated a giant cystic-solid mass on the left kidney, which occupied a large pa...

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“…Nineteen giant PCCs larger than 10 cm have been documented (Table 2). [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] In this group of studies, the mean age was 48 years (range: 12-81), with 58% being male. Eight cases presented asymptomatically at the time of diagnosis, 4 had hypertension, and 1 other in addition to this case presented with dyspnea accompanied with chest pain, paraesthesia, and palpitations.…”

Section: Discussionmentioning

confidence: 99%

Largest pheochromocytoma reported in Canada: A case study and literature review

Ambati

Jana

Domes

2014

CUAJ

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Most giant pheochromocytomas do not present with classic symptoms, as documented by published case reports. Given this, clinicians have to consider a wide differential diagnosis for any retroperitoneal mass and perform screening tests to rule out a pheochromocytoma. We describe the largest pheochromocytoma reported in Canada, where the patient presented with a palpable abdominal mass and dyspnea. The 19 × 18 × 12-cm right retroperitoneal mass was biochemically active and was radiologically and pathologically consistent with a giant pheochromocytoma. We present this case and review the relevant current literature.

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Giant Cystic Pheochromocytoma Located in the Renal Hilus

Cited by 19 publications

References 10 publications

Giant multicystic malignant pheochromocytoma

Giant multicystic malignant pheochromocytoma

Undiagnosed giant cystic pheochromocytoma: A case report

Largest pheochromocytoma reported in Canada: A case study and literature review

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