Wang Jian, Yuan Ding, Lu Ya, Ma Yukui, Huang Bin, Yang Yi, Zhao Jichun
Department of Vascular Surgery, The West China Medical School of Sichuan University, West China Hospital of Sichuan University, Chengdu, Sichuan.
Department of Vascular Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province.
Medicine (Baltimore). 2019 Jul;98(29):e16494. doi: 10.1097/MD.0000000000016494.
It is difficult to discriminate malignant pheochromocytoma (PCC) from benign PCC. The requirement of abdominal aortic and inferior vena cava reconstruction is extremely rare.
We here report a case of a large pheochromocytoma in a 56-year-old woman who complained of only hand trembling and had no hypertension or other symptoms. The operation was difficult because of a tight adhesion to the circumference of great vessels. A replacement of the aortocaval vessels with grafts was necessary to remove the tumor completely.
Ultrasonography, computed tomography (CT), and catecholamine assay revealed suspecting the retroperitoneal PCC.
Tumor excision and reconstruction of the abdominal aorta and inferior vena cava by externally supported polytetrafluoroethylene (ePTFE) vessels were successfully performed.
A follow-up CT angiography showed no recurrence and graft vessels presented good patency after 7years. Catecholamine in urine and serum assay was normal.
The complete resection of the tumor and infiltrated great vessels were necessary for the long-term survival of patients with a large PCC. The ePTFE graft is a good substitute for vessel reconstruction.
区分恶性嗜铬细胞瘤（PCC）和良性PCC很困难。腹主动脉和下腔静脉重建的需求极其罕见。
我们在此报告一例56岁女性的巨大嗜铬细胞瘤病例，该患者仅主诉手部颤抖，无高血压或其他症状。由于与大血管周围紧密粘连，手术困难。为了完全切除肿瘤，需要用移植物替换主动脉腔静脉血管。
超声、计算机断层扫描（CT）和儿茶酚胺检测提示怀疑腹膜后PCC。
成功进行了肿瘤切除，并通过外部支撑的聚四氟乙烯（ePTFE）血管对腹主动脉和下腔静脉进行了重建。
术后7年的随访CT血管造影显示无复发，移植血管通畅良好。尿和血清儿茶酚胺检测正常。
对于巨大PCC患者的长期生存，完全切除肿瘤及受侵大血管是必要的。ePTFE移植物是血管重建的良好替代品。
