Ohta Mineto, Fujio Atsushi, Miyagi Shigehito, Tokodai Kazuaki, Nakanisihi Wataru, Unno Michiaki, Kamei Takashi
Department of Surgery, Graduate School of Medicine, Tohoku University, Japan.
Department of Surgery, Graduate School of Medicine, Tohoku University, Japan.
Int J Surg Case Rep. 2021 Apr;81:105712. doi: 10.1016/j.ijscr.2021.105712. Epub 2021 Feb 27.
Pheochromocytomas arise from the adrenal medulla and are rare. Pheochromocytomas metastasize to bone, lung and liver, and surgery might be the curative treatment. However, few cases are detected when they are resectable lesions because of difficulty in diagnosis and rapid growth. We herein report a patient who underwent resection of liver metastasis and local recurrence of pheochromocytoma.
A 74-year-old woman visited our hospital for treatment for liver and retroperitoneal tumors. She had undergone left adrenal gland resection for pheochromocytoma 16 years earlier. Eleven years after primary surgery, breast cancer was diagnosed and resected. During the breast cancer follow-up, a liver tumor was identified with computed tomography. Breast cancer recurrence and metastasis were considered, so chemotherapy was administered first. However, the liver tumor gradually enlarged, and another lesion appeared in the retroperitoneum. The tumors were diagnosed as pheochromocytoma recurrence using I-metaiodobenzylguanidine scintigraphy, and she underwent resection of the local recurrence and liver metastasis. She was discharged on postoperative day 25 without complications, and no evidence of recurrence occurred more than 3.5 years postoperatively.
All pheochromocytomas have metastatic potential; however, there are no reliable markers to predict malignancy. Early detection of recurrence by regular imaging and complete resection are important in the treatment. If the recurrence was oligometastasis and tumor growth is slow, surgical resection may be eligible.
A favorable outcome resulted from complete resection for liver metastasis and local recurrence of pheochromocytoma.
嗜铬细胞瘤起源于肾上腺髓质，较为罕见。嗜铬细胞瘤可转移至骨骼、肺和肝脏，手术可能是治愈性治疗方法。然而，由于诊断困难且生长迅速，很少有病例在可切除病灶时被发现。我们在此报告一例接受嗜铬细胞瘤肝转移及局部复发切除术的患者。
一名74岁女性因肝脏及腹膜后肿瘤前来我院治疗。她16年前曾因嗜铬细胞瘤接受左肾上腺切除术。初次手术后11年，被诊断出乳腺癌并接受了手术。在乳腺癌随访期间，通过计算机断层扫描发现肝脏有肿瘤。考虑为乳腺癌复发和转移，因此首先进行了化疗。然而，肝脏肿瘤逐渐增大，腹膜后又出现了另一个病灶。通过间碘苄胍闪烁显像将肿瘤诊断为嗜铬细胞瘤复发，她接受了局部复发灶及肝转移灶的切除术。术后第25天出院，无并发症，术后3.5年以上无复发迹象。
所有嗜铬细胞瘤都有转移潜能；然而，尚无可靠的标志物来预测恶性程度。通过定期影像学检查早期发现复发并完整切除在治疗中很重要。如果复发为寡转移且肿瘤生长缓慢，手术切除可能是合适的。
嗜铬细胞瘤肝转移及局部复发的完整切除带来了良好的结果。
