Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Fukuoka, Japan.
Department of Pathology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Fukuoka, Japan.
Ann Thorac Cardiovasc Surg. 2022 Jun 20;28(3):232-235. doi: 10.5761/atcs.cr.20-00162. Epub 2020 Oct 16.
We describe a rare case of newly discovered pulmonary metastases and surgical confirmation 12 years after initial surgery for a pheochromocytoma. A 61-year-old asymptomatic man was referred because of an abnormal shadow in the right lung field upon chest radiography. Computed tomography (CT) showed two well-demarcated tumors in the basal segment of the right lung. Twelve years previously, he underwent right adrenalectomy and was pathologically diagnosed as having a benign pheochromocytoma. Thereafter, he received a medical check-up annually. To confirm the diagnosis of two pulmonary tumors, video-assisted thoracic surgery was done and wedge resection of the right lower lobe completed. Pathology studies revealed these tumors as pulmonary metastases from the pheochromocytoma, which indicated that the true diagnosis was a malignant pheochromocytoma. Patients with a benign pheochromocytoma should continue to undergo careful monitoring for a long time after the initial surgical procedure. Thoracic surgeons should be aware of the possibility of pulmonary metastases even if >10 years have passed since initial resection of a benign pheochromocytoma.
我们描述了一例罕见的病例，该患者在最初因嗜铬细胞瘤行手术治疗 12 年后新发现肺部转移，并经手术证实。一名 61 岁无症状男性因胸部 X 线检查发现右肺野异常阴影而被转诊。计算机断层扫描（CT）显示右肺基底段有两个界限清楚的肿瘤。12 年前，他接受了右肾上腺切除术，并被病理诊断为良性嗜铬细胞瘤。此后，他每年接受一次体检。为了明确两个肺部肿瘤的诊断，进行了电视辅助胸腔镜手术，并完成了右下肺楔形切除术。病理研究显示这些肿瘤是来自嗜铬细胞瘤的肺部转移，这表明真正的诊断是恶性嗜铬细胞瘤。患有良性嗜铬细胞瘤的患者在初次手术治疗后应长期进行仔细监测。即使在良性嗜铬细胞瘤初次切除后已经过去了 10 年以上，胸外科医生也应该意识到发生肺部转移的可能性。
