Laparoscopic adrenalectomy for large pheochromocytoma
a challenging case report
DOI:
https://doi.org/10.11606/issn.1679-9836.v99i3p319-322Keywords:
Pheochromocytoma, Neuroendocrine tumors, Laparoscopy, AdrenalectomyAbstract
Pheochromocytoma is a rare neuroendocrinal tumor, cause of severe hypertension and excretion of catecholamines. The gold standard treatment is laparoscopic adrenalectomy, however when the tumor is more than 6 cm laparoscopy access is controversy. The patient was a 41-year-old man with severe hypertension and important weight loss. CT showed a adrenal mass with contrast enhancement and central necrosis with 10x8cm. Laboratory exams demonstrated serum calcium of 12.5mg/dL, high urinary catecholamines at the expense of noradrenaline (13 936 ug/24h) and serum noradrenaline of 7451 pg/ml. The authors performed an adrenalectomy of a large tumor by laparoscopic approach without major complications. Histopathology showed pheochromocytoma with 11x8 cm and 285 gr without capsular involvement. This case report may bring information about adrenal tumors management and shows that large pheochromocytomas are challenging cases, but if well programmed can be done by minimally invasive access with safety.
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References
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