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Case Reports
. 2018 May-Jun;32(3):703-706.
doi: 10.21873/invivo.11297.

Surgical Management of a Giant Pheochromocytoma

Amer Afaneh  1 , Michael Yang  1 , Ameer Hamza  1 , Edward Schervish  1 , Richard Berri  2
Affiliations
Case Reports

Surgical Management of a Giant Pheochromocytoma

Amer Afaneh et al. In Vivo. 2018 May-Jun.

Abstract

Pheochromocytomas are rare tumors arising from chromaffin cells of the adrenal medulla and extramedullary sympathetic ganglia. The incidence of asymptomatic disease is rising due to increased detection rates from widespread use of computed tomography. We describe a case of one of the largest documented pheochromocytomas resected in the United States, an 18-cm tumor in a patient who presented with exertional dyspnea, abdominal pain, constipation, weight loss, and intermittent hypertension. After biochemical and appropriate imaging workup, the patient underwent an open resection of the mass.

Keywords: Pheochromocytoma; adrenal; endocrine; kidney; paraganglionoma.

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Figures

Figure 1
Figure 1. Computed tomography revealed a large left-sided retroperitoneal mass with highly vascular features
Figure 2
Figure 2. 123I-Meta-iodobenzylguanidine scan showing a large leftsided mass.
Figure 3
Figure 3. Initial view upon entering the abdomen
Figure 4
Figure 4. Resected mass, with greatest dimension of 18 cm.
Figure 5
Figure 5. Microscopic evaluation of the tumor revealed small nests of tumor cells surrounded by capillaries (H&E stain; a: ×100; b: ×200).
Figure 6
Figure 6. Microscopic evaluation of the tumor revealed neoplastic cells with hyperchromatic nuclei containing finely stippled chromatin (H&E stain;×400).
Figure 7
Figure 7. Neoplastic cells were found to be immunoreactive for chromogranin (×20).
See this image and copyright information in PMC

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