Open AccessNon-syndromic pheochromocytoma: From post-operatory scores to lifetime follow-up
Author(s) -
Mihai Cristian DUMITRASCU,
Diana Elena BECHERU,
Е. С. Петрова,
Anda Dumitrașcu,
Adina Ghemigian,
Mara Cârșote,
M Popescu,
Florica Șandru
Publication year - 2021
Publication title -
romanian journal of medical practice
Language(s) - English
Resource type - Journals
eISSN - 2069-6108
pISSN - 1842-8258
DOI - 10.37897/rjmp.2021.3.14
Subject(s) - medicine , pheochromocytoma , pathological , adrenalectomy , blood pressure , abdomen , population , surgery , urology , radiology , environmental health
We introduce a case report of an adult male diagnosed with non-syndromic pheochromocytoma with a first pathological post-operatory report of malignant type with further re-considerations during follow-up for a 6-year period of time. This is 46 - year old male admitted for: post-adrenalectomy status reassessment. In 2013 he was diagnosed with high blood pressure requiring a complex regime of anti-hypertensive drugs to control it. In 2015 he was referred for an endocrine check-up which revealed a pheochromocytoma (noradrenaline type). Computed tomography imaging of the abdomen showed a right adrenal tumor of 28/38 mm, a mass that was clearly contoured, with heterogeneous pattern, and with moderate caption of intravenous contrast. Laparoscopic right adrenalectomy is performed with normalization of high pre-operatory normetanephrines and a dose reduction of anti-hypertensive medication which was still necessary. Pathological report suggested a malignant pheochromocytoma; the initial PASS score of 8 was later re-calculated, and a GAPP score of 5 was achieved showing a moderately differentiated tumor. No genetic backup was identified. Within the first year after tumor removal, the patient suffered a stroke, proving the higher cardiovascular risk than general population even after hormonal imbalance is restored. Lifelong surveillance is the rule.