Very late recurrence of an apparently benign pheochromocytoma

Thai, Elena; Gnetti, Letizia; Gilli, Annalisa; Caruana, Pietro; Valle, Raffaele Dalla; Buti, Sebastiano

doi:10.4103/0973-1482.154942

Cited by 10 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our case, pathological findings suggested an intermediate risk of tumor metastasis but displayed no signs of recurrence during more than half a year of the postoperative follow-up period. Given that a recurrence of pheochromocytoma may occur even decades after surgery [ 12 ], further follow-ups will be mandatory for a long time in our case.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Size of a Ruptured Pheochromocytoma after Transcatheter Arterial Embolization

Ichikawa

Oyabu

Minamida

et al. 2021

Case Reports in Medicine

View full text Add to dashboard Cite

The spontaneous rupture of a pheochromocytoma is rare and can be potentially fatal. We report a case of a tumor size reduction of a ruptured pheochromocytoma after transcatheter arterial embolization (TAE). A 60-year-old Japanese woman was referred to the emergency department of another hospital with a sudden onset of left lateral pain. Computed tomography of the abdomen revealed adrenal hemorrhage with a 5.7 cm adrenal mass, and she was transferred to our hospital for treatment. Considering that she had marked hypertension (193/115 mmHg), we made a provisional diagnosis of left lateral pain due to a ruptured pheochromocytoma. She underwent TAE, and the hemorrhage was successfully controlled. She was started on oral doxazosin for hypertension. The dose of doxazosin was increased to the extent that orthostatic hypotension did not develop, and blood pressure was well controlled. After discharge, the tumor size gradually decreased to approximately 1.0 cm within six months. Six months after TAE, elective laparoscopic surgery was performed, and the diagnosis was confirmed by histopathology. We observed a decrease in the size of the ruptured pheochromocytoma after TAE. To reduce the risk of laparoscopic adrenal surgery, it may be useful to monitor the size of a ruptured pheochromocytoma after TAE before deciding the surgery time.

show abstract

Section: Discussionmentioning

confidence: 99%

Changes in the Size of a Ruptured Pheochromocytoma after Transcatheter Arterial Embolization

Ichikawa

Oyabu

Minamida

et al. 2021

Case Reports in Medicine

View full text Add to dashboard Cite

show abstract

“…Our patient exhibited a solitary unilateral adrenal pheochromocytoma that had a PASS of 2 and experienced no recurrence during postoperative follow-up for more than 7 years. Since recurrence of pheochromocytoma may occur even decades after surgery [ 21 ], further careful follow-up was needed in our patient.…”

Section: Discussionmentioning

confidence: 99%

Histopathological analysis of spontaneous large necrosis of adrenal pheochromocytoma manifested as acute attacks of alternating hypertension and hypotension: a case report

et al. 2016

View full text Add to dashboard Cite

BackgroundPheochromocytomas are rare catecholamine-producing neuroendocrine tumors. Hypertension secondary to pheochromocytoma is often paroxysmal, and patients occasionally present with sudden attacks of alternating hypertension and hypotension. Spontaneous, extensive necrosis within the tumor that is associated with catecholamine crisis is an infrequent complication of adrenal pheochromocytoma, but its pathogenesis remains unclear.Case presentationA 69-year-old Japanese man developed acute-onset episodic headaches, palpitations, and chest pains. During the episodes, both marked fluctuations in blood pressure (ranging from 40/25 to 300/160 mmHg) and high plasma levels of catecholamines were found simultaneously. Radiological findings indicated a 4-cm left adrenal pheochromocytoma. These episodic symptoms disappeared within 2 weeks with normalization of plasma catecholamine levels. Two months later, the patient underwent adrenalectomy. Microscopic examinations revealed pheocromocytoma with a large central area of coagulative necrosis. The necrotic material was immunohistochemically positive for chromogranin A. Granulation tissue was adjacent to the necrotic area, accompanied by numerous hemosiderin-laden macrophages and histiocytes with vascular proliferation. Viable tumor cells, detected along the periphery of the tumor, demonstrated pyknosis, and the Ki-67 labeling index was 2 % in the hot spot. No embolus or thrombus formation was found in the resected specimen harboring the whole tumor. The Pheochromocytoma of the Adrenal gland Scaled Score was 2 out of 20. The patient’s postoperative course was unremarkable for > 7 years.ConclusionsPresumed causal factors for the extensive necrosis of adrenal pheochromocytoma in previously reported cases include hemorrhage into the tumor, hypotension induced by a phentolamine administration, embolic infarction, high intracapsular pressure due to malignant growth of the tumor, and catecholamine-induced vasoconstriction. In the present case, histopathological and clinical findings suggest that under conditions of chronic ischemia due to catecholamine-induced vasoconstriction, an acute infarction occurred after sudden attacks of alternating hypertension and hypotension. Over the subsequent 2 weeks, repetitive massive release of catecholamines from the infarcts into circulation likely accelerated infarction progression by causing repeated attacks of alternating hypertension and hypotension and resulted in the large necrosis. This case highlights the need for physicians to consider acute spontaneous tumor infarction accompanying episodic catecholamine crisis as a rare but severe complication of pheochromocytoma.

show abstract

“…se javiti i kao maligni tumori s metastazama, najčešće u jetru, limfne čvorove i kosti 4,11 . Malignitet kod ekstraadrenalnih paraganglioma iznosi 20 %, a adrenalnih 10 % 9 .…”

Section: Raspravaunclassified

“…Malignitet kod ekstraadrenalnih paraganglioma iznosi 20 %, a adrenalnih 10 % 9 . Na malignitet upućuju rizični čimbenici: veličina tumora veća od 5 -6 cm, težina veća od 8 g, abnormalni DNK uzorci, visoka koncentracija dopamina koja cirkulira i visoke razine dopamina u tumoru, kao i postoperativna hipertenzija 11 . Feokromocitomi su se opisivali kao "10 % tumori" jer se smatralo da je približno 10 % tumora bilateralno, 10 % ektraadrenalno, 10 % u sklopu obiteljskih sindroma, a 10 % maligno.…”

Section: Raspravaunclassified

Feokromocitom: put od prvih simptoma do dijagnoze

Marušić

Turk

Degmečić

et al. 2021

Med. Flum. (Online)

View full text Add to dashboard Cite

Cilj: Prikazati slučaj pacijenta obrađenog zbog gubitka na tjelesnoj masi i anksioznosti kojemu je utvrđen tumor srži nadbubrežne žlijezde, a naknadnim uvidom u medicinsku dokumentaciju utvrđene su i višegodišnje povremene palpitacije, tahikardije i skokovi tlaka. Prikaz slučaja: Prikazan je šezdesetdvogodišnji pacijent koji se žalio na oslabljen apetit unatrag 3 mjeseca, gubitak na tjelesnoj masi 10 kg te anksioznost. Ultrazvukom abdomena utvrđena je, a kompjutoriziranom tomografijom (CT) abdomena potvrđena, oštro ograničena heterogena tvorba desne nadbubrežne žlijezde promjera 4,2 x 5 cm i denziteta 26 Hounsfieldovih jedinica. Iz medicinske dokumentacije saznaje se da je prethodnih 4 godina povremeno imao palpitacije i supraventrikularne tahikardije s vrijednostima krvnog tlaka do 190/100 mmHg. Endokrinološkom obradom utvrđene su povišene vrijednosti metanefrina i normetanefrina u plazmi (12 i 9 puta). Nakon operacije patohistološki je potvrđena dijagnoza feokromocitoma. Kontrolni nalazi metanefrina i normetanefrina bili su uredni. Planira se kontrola metanefrina i normetanefrina u plazmi jedanput godišnje. Zaključak: U ovom prikazu slučaja želi se istaknuti važnost postavljanja sumnje i pravovremenog utvrđivanja feokromocitoma te sprječavanja mogućih komplikacija. Ako postoji klinička sumnja na feokromocitom ili je tijekom obrade incidentaloma nadbubrežne žlijezde CT-om isključeno da se radi o adenomu, potrebno je učiniti biokemijsku obradu feokromocitoma. Ako se ne prepoznaju na vrijeme, ovi tumori zbog svoje hipersekrecije katekolamina imaju visok kardiovaskularni morbiditet i mortalitet.

show abstract

Very late recurrence of an apparently benign pheochromocytoma

Cited by 10 publications

References 0 publications

Changes in the Size of a Ruptured Pheochromocytoma after Transcatheter Arterial Embolization

Changes in the Size of a Ruptured Pheochromocytoma after Transcatheter Arterial Embolization

Histopathological analysis of spontaneous large necrosis of adrenal pheochromocytoma manifested as acute attacks of alternating hypertension and hypotension: a case report

Feokromocitom: put od prvih simptoma do dijagnoze

Contact Info

Product

Resources

About