Perioperative Management of Adrenalectomy and Inferior Vena Cava Reconstruction in a Patient With a Large, Malignant Pheochromocytoma With Vena Caval Extension

Gregory, Stephen H.; Yalamuri, Suraj; McCartney, Sharon L.; Shah, Syed Qaiser; Sosa, Julie Ann; Roman, Sanziana A.; Colin, Brian J.; Lentschener, Claude; Munroe, Ray; Patel, Saumil; Feinman, Jared W.; Augoustides, John

doi:10.1053/j.jvca.2016.07.019

Cited by 3 publications

(2 citation statements)

References 81 publications

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“…The evaluation and management of patient with pheos should be multidisciplinary with appropriate expertise to ensure favorable outcomes (Lenders et al 2014). Adequate preoperative evaluation is crucial before surgery for patients with pheos (Pappachan et al 2014;Gregory et al 2017;Naranjo et al 2017). Preoperative evaluation should include a thorough patient's and family history, complete blood count, metabolic profile, plasma metanephrines, ECG and cardiac ultrasound (to check for cardiac compromise).…”

Section: Treatmentmentioning

confidence: 99%

“…Pheo has pathophysiological characteristics of low blood volume, hypertension, and high blood concentrations of catecholamine which can lead to catecholamine cardiomyopathy (Harari and Inabnet 2011;Renard et al 2011;Pappachan et al 2014;Sanford et al 2015;Gregory et al 2017;Ramachandran and Rewari 2017;Weiner et al 2017). Cardiomyopathy due to pheo is reversible (Pappachan et al 2014).…”

Section: Treatmentmentioning

confidence: 99%

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Pheochromocytoma

Farrugia¹,

Anestis

2019

Endocrine Regulations

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Pheochromocytomas are rare tumors originating in the adrenal medulla. They may be sporadic or in the context of a hereditary syndrome. A considerable number of pheochromocytomas carry germline or somatic gene mutations, which are inherited in the autosomal dominant way. All patients should undergo genetic testing. Symptoms are due to catecholamines over production or to a mass effect. Diagnosis is confirmed by raised plasma or urine metanephrines or normetanephrines. Radiology assists in the tumor location and any local invasion or metastasis. All the patients should have preoperative preparation with α-blockers and/or other medications to control hypertension, arrhythmia, and volume expansion. Surgery is the definitive treatment. Follow up should be life-long.

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