Giant cystic malignant pheochromocytoma invading right hepatic lobe
report on two cases
Keywords:
Pheochromocytoma, Neuroendocrine tumors, Hepatectomy, Adrenalectomy, Case reports [publication type]Abstract
CONTEXT: Cystic pheochromocytomas are uncommon neuroendocrine tumors that originate from the adrenal medulla. Differing from the more frequent solid pheochromocytomas, which produce catecholamines and present adrenergic syndrome, cystic pheochromocytomas may not produce these. Their symptoms are generally associated with an abdominal mass or even pain, particularly if the mass attains large dimensions. Similarly, radiological diagnosis may also be diffi cult. Right-side lesions may be confounded with cystic hepatic tumors or even retroperitoneal sarcomas with cystic areas, using radiological methods. Sometimes, there may be a preoperative diagnosis of malignancy. Invasion of organs in this region (i.e. liver or kidney), or even the presence of a large retroperitoneal mass (of uncertain origin) with which multiple organs are involved, may be indicative of malignant origin. CASE REPORT: Two cases of giant cystic pheochromocytoma that invaded the right hepatic lobe are described. These presented as abdominal masses. Both cases were malignant. They were treated by radical right nephrectomy plus right hepatectomy.
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References
Pederson LC, Lee JE. Pheochromocytoma. Curr Treat Options Oncol. 2003;4(4):329-37.
Pereira MA, Souza BF, Freire DS, Lucon AM. Feocromoci- toma. [Pheochromocytoma]. Arq Bras Endocrinol Metabol. 2004;48(5):751-75.
Bravo EL, Tagle R. Pheochromocytoma: state-of-the-art and future prospects. Endocr Rev. 2003;24(4):539-53.
Antedomenico E, Wascher RA. A case of mistaken identity: giant cystic pheochromocytoma. Curr Surg. 2005;62(2):193-8.
Fan MH, Chang AE. Resection of liver tumors: technical aspects. Surg Oncol. 2002;10(4):139-52.
Lee TH, Slywotzky CM, Lavelle MT, Garcia RA. Cystic pheo- chromocytoma. Radiographics. 2002;22(4):935-40.
Goldstein RE, O’Neill JA Jr, Holcomb GW 3rd, et al. Clinical experience over 48 years with pheochromocytoma. Ann Surg. 1999;229(6):755-64; discussion 764-6.
Landsberg L, Young JP. Pheochromocytoma. In: Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s principles of internal medicine. 15th ed. New York: McGraw-Hill; 2001. p. 2105-9.
Norton AJ. Adrenal Tumors, Pheochromocytoma. In: DeVita Jr VT, Hellman S, Rosenberg SA, editors. Cancer: principles and practice of oncology. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 1770-8.
Melegh Z, Rényi-Vámos F, Tanyay Z, Köves I, Orosz Z. Giant cystic pheochromocytoma located in the renal hilus. Pathol Res Pract. 2002;198(2):103-6; discussion 107-8.
Wu JS, Ahya SN, Reploeg MD, et al. Pheochromocy- toma presenting as a giant cystic tumor of the liver. Surgery. 2000;128(3):482-4.
Bush WH, Elder JS, Crane RE, Wales LR. Cystic pheochromo- cytoma. Urology. 1985;25(3):332-4.
Klinger PJ, Fox TP, Menke DM, Knudsen JM, Fulmer JT. Pheochromocytoma in an incidentally discovered asymptomatic cystic adrenal mass. Mayo Clin Proc. 2000;75(5):517-20.
Tazi K, Elmalki HO, Ei Fassi MJ, Koutani A, Hachimi M, Lakrissa A. Une forme rare de phéochromocytome surrénalien: masse kystique asymptomatique. [Unusual form of adrenal pheochromocytoma: asymptomatic cystic mass]. Prog Urol. 2001;11(2):293-5.
Minei S, Yamashita H, Koh H, et al. [Giant cystic pheochromo- cytoma: a case report]. Hinyokika Kiyo. 2001;47(8):561-3.
Matoba T, Fukumoto A, Takayama K, Yokota T, Toshima
H. Electrocardiogram and vectorcardiogram on paroxysmal hypertension of cystic pheochromocytoma. Report of a case. Jpn Heart J. 1965;6(5):483-9.
Gonzalez RJ, Lee JE. Adrenal Tumors. In: Feig BW, Berger DH, Fuhrman GM, editors. The M.D. Anderson surgical oncology handbook. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 419-39.
