High incidence of morbidity following resection of metastatic pheochromocytoma in the spine

Abstract

<jats:p>Pheochromocytomas of the spine are uncommon and require careful preoperative planning. The authors retrospectively reviewed the charts of 5 patients with metastatic spinal pheochromocytoma who had undergone surgical treatment over the past 10 years at their medical center. They reviewed patient age, history of pheochromocytoma resection, extent and location of metastases, history of alpha blockage, surgical level, surgical procedure, postoperative complications, tumor recurrence, and survival. Metastases involved the cervical (1 patient), thoracic (3 patients), and lumbar (2 patients) levels. Preoperative treatment included primary pheochromocytoma resection, chemotherapy, alpha blockade, embolization, and radiation. Three patients had tumor recurrence, and 2 underwent 2-stage reoperations for tumor extension. Hemodynamic complications were common: 2 patients developed pulseless electrical activity arrest within 4 months after surgery, 1 patient had profound postoperative tachycardia with fever and an elevated creatine kinase level, and 1 patient experienced transient postoperative hypotension and paraplegia. One patient died of complications related to disseminated cerebral and spinal disease.</jats:p> <jats:p>With careful preoperative and surgical management, patients with symptomatic metastatic spinal pheochromocytoma can benefit from aggressive surgical treatment. Postoperative cardiovascular complications are common even months after surgery, and patients should be closely monitored long term.</jats:p>

En Bloc Resection of Solitary Functional Secreting Spinal Metastasis

“…Kaloostian et al described three patients in their case series who underwent intralesional resection. 19 A 41-year-old man with multiple lesions in the T5–T7 vertebrae underwent radiation followed by a T5–T7 decompression, with intralesional vertebrectomy. Postoperatively, he received chemotherapy, and 4 years after his initial spinal surgery, he presented with metastatic disease at T1.…”

Feohromocitom Kod Desetogodišnjeg Dječaka - Prikaz Slučaja

“…Incidenca feohromocitoma u opštoj populaciji iznosi 0,1 %. 2 Ukoliko se javi kod djece, često se nađe u sklopu sindroma (MEN, Sturge-Weber, Von Hippel-Lindau). Najčešće zahvata nadbubrežnu žlijezdu, mada može biti i ekstraadrenalni.…”

General Surgery Approach to Neurofibromatosis Cases

“…Multidisciplinary clinical evaluations are important in defining complications and neoplastic transformations. extra-adrenal pheochromocytoma or paraganglioma [22][23][24][25]. Pheochromocytomas may occur with some familial genetic syndromes [25].…”