Huge pheochromocytoma presented with paraaortic lymph node and spine metastases

박연원; 문한주; 한정석; 한지민; 박종욱; 구윤희

Huge pheochromocytoma presented with paraaortic lymph node and spine metastases

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척추와 대동맥주위 림프절로 전이한 거대 갈색세포종

Type: Academic journal

Author: 박연원 문한주 한정석 한지민 박종욱 구윤희

Journal: 영남대학교 의과대학 Journal of Yeungnam Medical Science Yeungnam University Journal of Medicine 제34권 제2호 KCI Accredited Journals

Published: 2017.1

Pages: 247 - 253 (7page)

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Huge pheochromocytoma presented with paraaortic lymph node and spine metastases

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Approximately 10-15% of pheochromocytomas are malignant. There are insufficient histologic criteria for the diagnosis of malignant pheochromocytoma. Thus, the term malignant pheochromocytoma is restricted to tumors with local invasion or distant metastases. We experienced a case of malignant pheochromocytoma recurred with spinal metastasis 4 years after the surgery for huge benign pheochromocytoma. A 68-year-old female was admitted for trunk and back pain. The patient had a history of surgery 4 years ago for a 10.0× 9.5×7.5 cm sized benign pheochromocytoma at the left adrenal gland. A thoracolumbar magnetic resonance imaging showed a tumor in the 7th thoracic vertebral body and a 24-hour urinary norepinephrine increased, suggesting metastatic recurrence of malignant pheochromocytoma. After metastasectomy in the 7th thoracic vertebral body, urine catecholamine was normalized and pain also disappeared. However, a metastatic lesion was found in the paraaortic area on a follow-up abdominal computed tomography scan and an additional metastasectomy was performed. The pathology confirmed the diagnosis of metastatic pheochromocytoma in the paraaortic lymph nodes. She is supposed to be treated with adjuvant iodine 131-meta-iodobenzylguanidine therapy. In our experience, a close follow-up should be considered in patients who had a huge benign pheochromocytoma due to the possibility of malignant metastases

#Adrenal gland neoplasms #Catecholamines #Pheochromocytoma #Metanephrines

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References (20)

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Choi SE / 1999 / Clinical analysis of malignant pheochromocytoma / J Korean Cancer Assoc 31 : 1307 ~ 1314

John H / 1999 / Pheochromocytomas:can malignant potential be predicted? / Urology 53 : 679 ~ 683

Kurisaki-Arakawa A / 2014 / A case of (123)I-MIBG scintigram-negative functioning pheochromocytoma: immunohistochemical and molecular analysis with review of literature / In

Lack EE / 1994 / Pathology of adrenal and extraadrenal paraganglia. Major problems in pathology. vol 29 / WB Saunders : 220 ~ 272

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