Annali italiani di chirurgia · 2023
Laparoscopic adrenalectomy for giant pheochromocytoma. What is the size limit ?
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Di Nuzzo Maria Michela, Castiglioni Simone, Pirozzi Nello, Di Santo Albini Andrea Gianmario, De Luca Marcello, Tedesco Anna, Bardascino Francesca, de Werra Carlo, Corcione Francesco
Аннотация
AIM: This case report describes a giant pheochromocytoma in a young female, experienced cardiac symptoms, treated by a transperitoneal laparoscopic right adrenalectomy.
MATERIAL AND METHODS: A 29 years old female with Taki-tsubo syndrome, consequent to the chronic release of catecholamines, with a palpable abdominal mass and vague abdominal symptoms was referred to our department. Abdominal CT scan has demonstrated a solid mass of 13 cm in the right adrenal space so, after pre-operative management with alpha-adrenergic receptor and beta blockade and a 3D CT scan reconstruction a right adrenalectomy laparoscopic approach was performed.
RESULTS: Our result underlines that 13 cm in size for a giant pheochromocytoma is not an absolute contraindication to perform a minimally invasive approach in expert hands, with optimal surgical, oncological and cosmetic results.
DISCUSSION: The only curative option for non-metastatic pheochromocytomas disease is surgical resection. Laparoscopic adrenalectomy is the treatment of choice but the limit size for a safe and feasible minimally invasive approach is not yet defined.
CONCLUSIONS: This case report could help to better define more solid recommendations in the next future and also provide landmarks and key steps for laparoscopic surgeons.
KEY WORDS: Giant Pheochromocytoma, Laparoscopic Adrenalectomy, Pheochromocytoma Management.
MATERIAL AND METHODS: A 29 years old female with Taki-tsubo syndrome, consequent to the chronic release of catecholamines, with a palpable abdominal mass and vague abdominal symptoms was referred to our department. Abdominal CT scan has demonstrated a solid mass of 13 cm in the right adrenal space so, after pre-operative management with alpha-adrenergic receptor and beta blockade and a 3D CT scan reconstruction a right adrenalectomy laparoscopic approach was performed.
RESULTS: Our result underlines that 13 cm in size for a giant pheochromocytoma is not an absolute contraindication to perform a minimally invasive approach in expert hands, with optimal surgical, oncological and cosmetic results.
DISCUSSION: The only curative option for non-metastatic pheochromocytomas disease is surgical resection. Laparoscopic adrenalectomy is the treatment of choice but the limit size for a safe and feasible minimally invasive approach is not yet defined.
CONCLUSIONS: This case report could help to better define more solid recommendations in the next future and also provide landmarks and key steps for laparoscopic surgeons.
KEY WORDS: Giant Pheochromocytoma, Laparoscopic Adrenalectomy, Pheochromocytoma Management.