A Pheochromocytoma with Liver Metastasis: What about Curative Surgery?

Introduction: 35% of pheochromocytomas are malignant and generally have a poor prognosis.Visceral metastases are associated with shorter survival. Treatments for advanced pheochromocytomas are essentially palliative. Surgery is potentially curative; however, tumor extension limits the chance for a curative resection.

Case Presentation: A 21-year-old women presented to our hospital with severe hypertension associated with Ménard's triad and heaviness of the left flank.The abdominal CT scan discovered a left adrenal mass with liver metastases. The diagnosis of pheochromocytoma was confirmed biochemically by the elevated catecholamine and metanephrine levels in the blood and urine. After preparation by the alpha-adrenergic blockade, she underwent left adrenalectomy and resection of left liver metastases followed by right hepatectomy. A pathology examination was performed and the final report was a metastatic pheochromocytoma with negative margins. She was discharged on postoperative without complications, and no evidence of recurrence occurred 48 months postoperatively.

Conclusion: complete resection of liver metastases from metastatic pheochromocytoma can improve survival and should also be considered in the event of predominant secreting symptoms.