Malignant pheochromocytoma with IVC thrombus.

A 61-year-old man presented with feeling of bloating, remarkable sweating, and body weight loss. We diagnosed right pheochromocytoma with inferior vena cava (IVC) thrombus by some plasma and urine catecholamine and their metabolites data and imaging findings. The patient underwent right adrenalectomy and IVC thrombectomy without use of cardiopulmonary bypass. Pathological finding showed potentially malignant pheochromocytoma. After operation, his subjective symptom disappeared, and abnormal plasma and urine catecholamine and their metabolites data fell to normal range. It is very important to get preoperative information of the exact location of tumor thrombus for the safe surgical management of pheochromocytoma with IVC thrombus. Magnetic resonance imaging (MRI) and ultrasound imaging more useful for diagnosis of the exact location of IVC thrombus.