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Improvement in renal dysfunction and symptoms after laparoscopic adrenalectomy in a patient with pheochromocytoma complicated by renal dysfunction
Authors:Fujiwara Mako  Imachi Hitomi  Murao Koji  Muraoka Tomie  Ohyama Tomoyo  Miyai Yumi  Kushida Yoshio  Haba Reiji  Kakehi Yoshiyuki  Ishida Toshihiko
Affiliation:(1) Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun Kagawa, 761-0793, Japan;(2) Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun Kagawa, 761-0793, Japan;(3) Department of Urology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun Kagawa, 761-0793, Japan
Abstract:A 70-year-old patient who was undergoing treatment for diabetes mellitus and chronic hepatitis was admitted to our hospital for evaluation of a tumor in the left adrenal gland (50 × 45 mm) and renal failure. On the basis of the patient’s increased serum concentrations of catecholamines and other metabolites and the results of positron emission tomography (PET), the patient was diagnosed with a pheochromocytoma; iodinated metaiodobenzylguanidine ([131I]MIBG) scintigraphy was insufficient to establish this diagnosis. Subsequently, he underwent surgery for tumor resection. Histological examination suggested the tumor to be a malignant pheochromocytoma. After left adrenalectomy was performed, the elevated catecholamine and metabolite concentrations and the blood pressure were restored to normal, and the patient’s symptoms of severe headaches and vertigo reduced. Furthermore, his renal function improved (Cr 2.0–1.2 mg/dl). Our patient exhibited a rare condition of pheochromocytoma complicated by renal failure, which was successfully treated with laparoscopic surgery.
Keywords:Malignant pheochromocytoma  Adrenal gland  Renal failure  Catecholamines  Laparoscopic surgery
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