Progress in diagnosis and treatment of cystic pheochromocytoma

Abstract

Abstract: Cystic pheochromocytoma is an uncommon neuroendocrine tumor, which mostly has no obvious clinical symptoms, and difficult to make correct diagnosis before surgical operation. When a cystic mass in the adrenal gland is found by imaging examination, the possibility of cystic pheochromocytoma should be screened. At present, the most curative treatment is surgical resection. Laparoscopic adrenalectomy is the first choice. Adequate preoperative preparation and strict postoperative monitoring are important pre-requisites for ensuring the safety of patients during the peri-operative period.

Key words: cystic pheochromocytoma, diagnosis, surgical operation

CLC Number:

R736.6

YANG Ting-kai, WEN Jin, JI Zhi-gang, DONG De-xin, YE Zi-xing. Progress in diagnosis and treatment of cystic pheochromocytoma[J]. Basic & Clinical Medicine, 2021, 41(7): 1066-1070.

References

[1]Li C, Chen Y, Wang W, et al. A case of clinically silent giant right pheochromocytoma and review of literature[J]. Can Urol Assoc J, 2012, 6: 267-269.
[2]Andreoni C, Krebs RK, Bruna PC, et al. Cystic phaeochromocytoma is a distinctive subgroup with special clinical, imaging and histological features that might mislead the diagnosis[J]. Br J Urol Int, 2008, 101: 345-350.
[3]Dai J, Chen SJ, Yang BS, et al. Recurrence of non-cardiogenic pulmonary edema and sustained hypotension shock in cystic pheochromocytoma[J]. J Zhejiang Univ Sci B, 2017, 18: 449-452.
[4]Wang H, Sun B, Xu Z, et al. Undiagnosed giant cystic pheochromocytoma: A case report[J]. Oncol lett, 2015, 10: 1444-1446.
[5]Yagnik VD, Joshipura V, Sadhu R. Cystic pheochromocytoma masquerading as a cystic pancreatic tumour[J]. ANZ J Surg, 2019, 89: 195-197.
[6]Eisenhofer G, Prejbisz A, Peitzsch M, et al. Biochemical diagnosis of chromaffin cell tumors in patients at high and low risk of disease: plasma versus urinary free or deconjugated O-methylated catecholamine metabolites[J]. Clin Chem, 2018, 64: 1646-1656.
[7]Unger N, Hinrichs J, Deutschbein T, et al. Plasma and urinary metanephrines determined by an enzyme immunoassay, but not serum chromogranin A for the diagnosis of pheochromocytoma in patients with adrenal mass[J]. Exp Clin Endocrinol Diabetes, 2012, 120: 494-500.
[8]Sarveswaran V, Kumar S, Kumar A, et al. A giant cystic pheochromocytoma mimicking liver abscess an unusual presentation-a case report[J]. Clin Case Rep, 2015, 3: 64-68.
[9]Erem C, Kocak M, Onder EH, et al. Epinephrine-secreting cystic pheochromocytoma presenting with an incidental adrenal mass: a case report and a review of the literature[J]. Endocrine, 2005, 28: 225-230.
[10]Kumar S, Parmar KM, Aggarwal D, et al. Simple adrenal cyst masquerading clinically silent giant cystic pheochromocytoma[J]. BMJ Case Rep, 2019, 12. doi: 10.1136/bcr-2019-230730.
[11]Antedomenico E, Wascher R. A case of mistaken identity: giant cystic pheochromocytoma[J]. Curr Surg, 2005, 62: 193-198.
[12]Galatola R, Romeo V, Simeoli C, et al. Characterization with hybrid imaging of cystic pheochromocytomas: correlation with pathology[J]. Quant Imaging Med Surg, 2021, 11: 862-869.
[13]Taieb D, Hicks R J, Hindie E, et al. European Association of Nuclear Medicine Practice Guideline/Society of Nuclear Medicine and Molecular Imaging Procedure Standard 2019 for radionuclide imaging of phaeochromocytoma and paraganglioma[J]. Eur J Nucl Med Mol Imaging, 2019, 46: 2112-2137.
[14]Machairas N, Papaconstantinou D, Papala A, et al. A huge asymptomatic pheochromocytoma[J]. Clin Case Rep, 2018, 6: 1366-1367.
[15]Cajipe KM, Gonzalez G, Kaushik D. Giant cystic pheochromocytoma[J]. BMJ Case Rep, 2017, 2017: doi: 10.1136/bcr-2017-222264.
[16]Park J, Song C, Park M, et al. Predictive characteristics of malignant pheochromocytoma[J]. Korean J Urol, 2011, 52: 241-246.
[17]Thompson LD. Pheochromocytoma of the Adrenal gland Scaled Score (PASS) to separate benign from malignant neoplasms: a clinicopathologic and immunophenotypic study of 100 cases[J]. Am J Surg Pathol, 2002, 26: 551-566.
[18]Costa S, Cabral N, Abhrao A, et al. Giant cystic malignant pheochromocytoma invading right hepatic lobe: report on two cases[J]. Sao Paulo Med J, 2008, 126: 229-231.
[19]Junejo SZ, Tuli S, Heimann DM, et al. A case report of cystic pheochromocytoma[J]. Am J Case Rep, 2017, 18: 826-829.
[20]Bouassida M, Samet A, Mseddi MA, et al. Laparoscopic treatment of a cystic pheochromocytoma of 6cms: a challenging case[J]. Urol Case Rep, 2019, 26. doi: 10.1016/j.eucr.2019.100978.
[21]Samejima M, Taguchi S, Miyagawa S, et al. Acute hypotension induced by suction of cystic fluid containing extremely high concentrations of catecholamines during resection of giant pheochromocytoma[J]. Int J Urol Case Rep, 2019, 2: 218-220.
[22]Maharaj R, Parbhu S, Ramcharan W, et al. giant cystic pheochromocytoma with low risk of malignancy: a case report and literature review[J]. Case Rep Oncol Med, 2017, 2017. doi: 10.1155/2017/4638608.
[23]Clements HA, Wilson MS, Smith DM. Incidental giant cystic pheochromocytoma: a case report and review of the literature[J]. Scott Med J, 2020, 65: 64-70.
[24]Mishra A, Agarwal G, Agarwal A, et al. Laparoscopic adrenalectomy of large cystic pheochromocytoma[J]. Surg Endosc, 2001, 15: 220.doi:10.1007/s004640040036.
[25]Costa AC, Silwa M, Carvalho L, et al. Adrenal giant cystic pheochromocytoma treated by posterior retroperitoneoscopic adrenalectomy[J]. Int J Surg Case Rep, 2017, 30: 201-204.
[26]Martins D, Rodrigues D, Melo M, et al. Laparoscopic adrenalectomy as an effective approach to massive bilateral pheochromocytomas[J]. BMJ Case Rep, 2017, 2017.doi:10.1136/bcr-2017-221009.
[27]Liu H, Li B, Yu X, et al. Perioperative management during laparoscopic resection of large pheochromocytomas: A single-institution retrospective study[J]. J Surg Oncol, 2018, 118: 709-715.
[28]Lee T, Slywotzky C, Lavelle M, et al. Cystic pheochromocytoma[J]. Radiographics, 2002, 22: 935-940.