Diagnosis and treatment experience of ectopic para-aortic pheochromocytoma

Abstract

Objective To investigate the diagnosis and treatment of ectopic para-aortic pheochromocytoma. Methods Clinical data of 2 cases with ectopic para-aortic pheochromocytoma in the Third Affiliated Hospital of Sun Yat-sen University from August 2012 to December 2013 were analyzed retrospectively. The informed consents of both patients were obtained and local ethical committee approval had been received. Both patients were female with the age of 54, 57 years old. The occurrence of disease, diagnosis, treatments and efficacy were observed. Results Case 1 was admitted in hospital for complaint of 1-month distending pain in upper abdominal and finding of retroperitoneal space-occupying lesion for 8 d. Solid space-occupying lesion at the right side of mid-upper abdomen was found by abdominal ultrasound and computer tomography (CT) examination. The preoperative diagnosis was abdominal mesenchymoma. Case 2 was admitted in hospital for complaint of palpitation, chest pain and finding of hepatic space-occupying lesion for 10 d and had a history of 5-year hypertension. Cystic solid space-occupying lesion in the hepatic caudate lobe was found by abdominal ultrasound, CT and magnetic resonance imaging (MRI) examinations and cystadenoma was suspected. The 2 patients underwent resection of ectopic para-aortic pheochromocytoma under general anesthesia by tracheal intubation. The intraoperative exploration found that touching the tumor had great impacts on blood pressure and heart rate and ectopic para-aortic pheochromocytoma was diagnosed. The patients were transferred to surgical intensive care unit (ICU) for monitoring and treatment. Pheochromocytoma was confirmed by the pathological examination. The patients were recovered and discharged from hospital and remained well till the paper submission date. Conclusions Ectopic para-aortic pheochromocytoma is a rare disease without characteristic clinical features. It is difficult for preoperative diagnosis. The confirmation is mainly depends on the pathological findings. Surgical resection is the priority of treatment. Fully assessment of operative risk before operation, avoiding touching tumor tissues during operation, complete excision of tumor capsule, close monitoring on the blood pressure after operation can achieve a good clinical treatment outcome. Key words: Pheochromocytoma; Paraneoplastic endocrine syndromes; Aorta, abdominal; Surgical procedures, operative