Metachronous pheochromocytoma metastasis to the upper dorsal spine—6-year survival (original) (raw)
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Bone metastasis of malignant pheochromocytoma four years after adrenalectomy
Russian Open Medical Journal, 2016
Malignant adrenal pheochromocytoma is an uncommon entity with low 5-year survival rate. Early diagnosis and adrenalectomy often yields good clinical outcome. The aim of the present case study is to report a 64-year-old Brazilian man with bone metastases of malignant pheochromocytoma first diagnosed and treated by right adrenalectomy four years ago. Recent evidence emphasized the recommendation about the safest duration of follow up, which should be at least 10 years from the first operation or first diagnosis of adrenal pheochromocytoma.
Key Words: epidural spinal metastasis, malignant pheochromocytoma, surgical removal In this case report, a thoracic extradural metastatic pheochromocytoma without bony invasion, is presented. The disease which has been identified with it's symptoms, bio-chemical features, radiological appearance, histological diagnosis has been discussed in comparison with malignant pheochromocytoma metastases in the literature. The origin of this tumor is the adrenal glands. Our review of the literature shows that tumor has primary metastasis in bony structures of the spine and then demonstrates secondary intraspinal invasion. This is the first case report of an epidural metastasis from malignant pheochromocytoma without a bony invasion.
2019
In this case report, a thoracic extradural metastatic pheochromocytoma without bony invasion, is presented. The disease which has been identified with it's symptoms, biochemical features, radiological appearance, histological diagnosis has been discussed in comparison with malignant pheochromocytoma metastases in the literature. The origin of this tumor is the adrenal glands. Our review of the literature shows that tumor has primary metastasis in bony structures of the spine and then demonstrates secondary intraspinal invasion. This is the first case report of an epidural metastasis from malignant pheochromocytoma without a bony invasion.
Surgical approach to rare case of recurrent pheochromocytoma and bones metastatic paraganglioma.
Background. Paraganglioma/Pheochromocytoma (PGL/ PCC) are neuroendocrine tumors characterized by association of paraganglioma and pheochromocytoma. PGLPCC are caused by mutations in a series of genes involved in cell metabolism. These genetic conditions can be both sporadics or less frequently hereditaries, usually diagnosed in younger patients. PCC-PGL incidence is about 1 in 300,000. PGL type 4 represents 5% of all PCC-PGL, it's related to SDHB mutations and has higher risk for malignancy than the other types. Malig-nancy is defined by presence of metastases that arise in sites devoid of chromaffin tissue such as bone. Malignant PGLs are extremely rare. Case presentation. The patient is a 37-year-old-female affected by paraganglioma in left paravertebral region and pheochromocytoma in the left adrenal gland (PPGL type 4). Pheocromocytoma was suspected after sporadic episode of hypertensive crisis and in 2012 a diagnosis was obtained. Genetic analysis were performed and showed mutation of SDHB gene. The patient underwent a left adrenalectomy to remove left pheochromocytoma. In October 2016 laboratory tests and instrumental exams showed recurrence of pheochromocytoma in left adrenal loggia, a metastases involving D10 and other small oste-olytic areas spread in vertebral column and other bones. Meantime the patient complained lumbar and intercostal pain, blood pressure was always in normal range. A surgical intervention of nerve decompression was needed urgently. Our intervention consisted in metastasis exci-sion with apposition of bone cement and stabilization of column through polyaxial pedicle screw and bar.
Malignant Pheochromocytoma with Widespread Bony and Pulmonary Metastases
2018
Pheochromocytoma is a rare benign tumor of the adrenal gland. A select few cases may be malignant, and metastatic cases are exceedingly rare. It often presents with symptoms of catecholamine excess, such as sweating, palpitations, headaches, and characteristic paroxysmal hypertension. Due to its diffuse symptoms, it is difficult to diagnose and is often diagnosed late. We describe the unique case of a 44-year-old female patient who presented with uncontrolled hypertension and vomiting, accompanied by lower back pain. She was diagnosed with malignant pheochromocytoma with multiple metastases to the lungs, vertebrae, scapulae, and skull. Because of the advanced state of her disease, the patient was started on treatment with the chemotherapeutic combination of cyclophosphamide, vincristine, and dacarbazine. However, she had a complicated hospital course and died because of aspiration pneumonia and sepsis.
Metachronous Metastasis of Pheochromocytoma to the Clivus: Report of an Exceptional Case
Clinical Case Reports, 2020
Pheochromocytomas (PCC) are rare neuroendocrine tumors of the medulla of adrenal glands. Malignant pheochromocytomas are even rarer and forming 10-25% of all PCC. The only criterion to establish malignant behaviour being distant metastasis to site without chromaffin tissue. We report an exceptional case of metachronous intracranial metastasis of pheochromocytoma to the clival bone in a 59-years-old patient. The patient was managed surgically for a wright adrenal pheochromocytoma ten years before. Only six cases of intracranial metastasis of pheochromocytoma have been reported in the literature, and to the best of our knowledge, this is the seventh case and the first clival bone metastasis of this rare condition.
Patient Safety in Surgery, 2012
Malignant pheochromocytoma is a neuroendocrine tumor that originates from chromaffin tissue. Although osseous metastases are common, metastatic dissemination to the spine rarely occurs. Five years after primary diagnosis of extra-adrenal, abdominal pheochromocytoma and laparoscopic extirpation, a 53-year old patient presented with recurrence of pheochromocytoma involving the spine, the pelvis, both proximal femora and the right humerus. Magnetic resonance imaging and computed tomography revealed osteolytic lesions of numerous vertebrae (T1, T5, T10, and T12). In the case of T10, total destruction of the vertebral body with involvement of the rear edge resulted in the risk of vertebral collapse and subsequent spinal stenosis. Thus, dorsal instrumentation (T8-T12) and cement augmentation of T12 was performed after perioperative alpha- and beta-adrenergic blockade with phenoxybenzamine and bisoprolol. After thorough preoperative evaluation to assess the risk for surgery and anesthesia,...
Surgical treatment of metastatic pheochromocytomas of the spine: a systematic review
Journal of integrative neuroscience, 2021
Metastatic pheochromocytoma of the spine (MPS) represents an extremely rare and challenging entity. While retrospective studies and case series make the body of the current literature and case reports, no systematic reviews have been conducted so far. This systematic review aims to perform a systematic review of the literature on this topic to clarify the status of the art regarding the surgical management of MPS. A systematic review according to PRISMA criteria has been performed, including all studies written in English and involving human participants. 15 papers for a total of 44 patients were finally included in the analysis. The median follow-up was 26.6 months. The most common localization was the thoracic spine (54%). In 30 out of 44 patients (68%), preoperative medications were administered. Open surgery was performed as the first step in 37 cases (84%). Neoadjuvant treatments, including preoperative embolization were reported in 18 (41%) cases, while adjuvant treatments wer...
IMAGING DIAGNOSIS-METASTATIC ADRENAL PHEOCHROMOCYTOMA IN A DOG
Veterinary Radiology & Ultrasound, 2011
A 10-year-old Akita mix became acutely paraplegic. Upon magnetic resonance imaging, multiple, slightly T2-hyperintense, T1-isointense extradural masses, relative to spinal cord were found in the vertebral canal. The retroperitoneal masses had mixed T2-signal intensity. The contrast enhancement pattern for the spinal masses was both homogenous and heterogenous. The diagnosis was metastatic pheochromocytoma. Signal intensity of the tumors in this dog was similar to reports of pheochromocytoma in human beings. r 2011 Veterinary A 10-YEAR-OLD AKITA mix was evaluated for paraplegia that had progressed from right thoracic limb lameness and difficulty walking in the pelvic limbs. Deep pain perception was intact. Muscle atrophy was present in both pelvic limbs, throughout the lumbar spine, and right shoulder. Spinal reflexes were normal in all limbs. The neurologic findings were suggestive of multifocal lesions at C1-5 and T3-L3.
A giant malignant pheochromocytoma of the adrenal gland: biologic time bomb
The Internet Journal of Oncology, 2009
BACKGROUND:Pheochromocytoma is a rare tumor of adrenal medulla and only 5-10% of pheochromocytoma are malignant. Surgical resection is the only mode of treatment .Methods:A case report with review of literature is presented in briefResults: Overall prognosis in benign case: 5 yr survival rate is >90% and in malignant case: about 40%