ArticleJCEM case reports2026
Massive Pheochromocytomatosis Treated With Cytoreductive Surgery.
Article in JCEM case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
A 35-year-old woman presented in 2022 to the Carling Adrenal Center with recurrent palpitations, anxiety, and diaphoresis, 9 years after right laparoscopic adrenalectomy at a local hospital for pheochromocytoma, diagnosed during pregnancy with placental abruption. Biochemical evaluation revealed markedly elevated 24-hour urinary and plasma fractionated metanephrines. Imaging identified extensive intra-abdominal tumor implants and a solitary liver lesion, raising suspicion for pheochromocytomatosis vs metastatic disease. Genetic testing was negative for major known pathogenic variants. Cytoreductive surgery successfully resected more than 200 tumor deposits, including a 15.5 cm omental mass, without complications. Pathology confirmed pheochromocytomatosis, with the liver lesion identified as focal nodular hyperplasia. Postoperatively, symptoms resolved, biochemical markers significantly improved but remain at ∼2.5- to 3.8 times above normal range, indicating residual microscopic disease (40 months follow-up). This case highlights the feasibility of cytoreductive surgery for extensive pheochromocytomatosis and the challenging distinction between tumor seeding and metastatic pheochromocytoma, emphasizing the need for lifelong biochemical surveillance.
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