Metastatic pheochromocytoma to liver without elevation of metanephrines and catecholamines.

Autor:	López-Gómez J; Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Seccion XVI, C.P. 14080, Mexico. Electronic address: javierlopgom@hotmail.com., Salazar-Álvarez MA; Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Seccion XVI, C.P. 14080, Mexico., Adame RY; Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Seccion XVI, C.P. 14080, Mexico., Alfaro-Goldaracena A; Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Seccion XVI, C.P. 14080, Mexico., Flores-Vazquez ER; Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Seccion XVI, C.P. 14080, Mexico., Gonzalez-Infante SH; Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Seccion XVI, C.P. 14080, Mexico., Padilla-Rosciano AE; Surgical Department of Gastrointestinal Tumors, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Seccion XVI, C.P. 14080, Mexico., López-Basave HN; Surgical Department of Gastrointestinal Tumors, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Seccion XVI, C.P. 14080, Mexico.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2016; Vol. 29, pp. 71-75. Date of Electronic Publication: 2016 Oct 22.
DOI:	10.1016/j.ijscr.2016.10.050
Abstrakt:	Introduction: Malignant pheochromocytoma represents 10% of all patients with pheochromocytoma. Of these cases, only 5-9% presents without elevation of metanephrines and catecholamines. Presentation of Case: A 43-year-old female patient presented with an abdominal tumor. An exploratory laparotomy was performed and the final report was a pheochromocytoma. After ten years, multiple liver lesions were detected and surgical treatment was performed. Pathological evaluation revealed a malignant pheochromocytoma with negative margins after 5 years of follow-up without evidence of disease. Discussion: The recurrence rate of malignant pheochromocytoma is 15-20% at ten years and a 5-year survival rate that ranges from 50% to 80%. The presence of synchronous metastases is rare (10-27%), but have been reported until 20 years later with the most common metastatic sites being the local lymph nodes, bone (50%), liver (50%) and lung (30%). The prognostic factor such as size >6cm, age over 45 years, synchronous metastasis and no tumor excision are related with poor prognosis. Conclusion: Surgical treatment offers the best survival rate and the only chance of cure so far and the goal is an R0 resection as in our case. So it should be the treatment of choice. (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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