Pheochromocytoma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2] Mohammed Abdelwahed M.D [3]

Overview

Surgery is the mainstay of treatment for pheochromocytoma. Adrenalectomy, laparoscopic transabdominal and retroperitoneal approaches have been used successfully for non-metastatic abdominal pheochromocytomas.

The mainstay of treatment for pheochromocytoma is surgery. Surgical resection is usually done for patients with either:
- Benign localized tumor
- Unilateral pheochromocytoma- Unilateral adrenalectomy
- Bilateral pheochromocytomas- cortical-sparing adrenalectomy.^[1]

Two approaches have been used successfully for non-metastatic abdominal pheochromocytomas:
- Laparoscopic transabdominal
- Retroperitoneal^[2]
There are less complications associated with laparoscopic surgery than with open surgery.
Major intraoperative complications include:
- Intraoperative tumor capsule rupture
- Hypertensive crisis
- Myocardial infarctions
- Cerebrovascular hemorrhages
- Hemodynamic instability after tumor resection.
- Hypoglycemia ^[3]
- Severe hypotension ^[4]

Surgery is the mainstay of treatment for pheochromocytoma, even if it is asymptomatic.

↑ Lee JE, Curley SA, Gagel RF, Evans DB, Hickey RC (1996). "Cortical-sparing adrenalectomy for patients with bilateral pheochromocytoma". Surgery. 120 (6): 1064–70, discussion 1070-1. PMID 8957496.
↑ Nehs MA, Ruan DT (2011). "Minimally invasive adrenal surgery: an update". Curr Opin Endocrinol Diabetes Obes. 18 (3): 193–7. doi:10.1097/MED.0b013e32834693bf. PMID 21494137.
↑ Rafat C, Zinzindohoue F, Hernigou A, Hignette C, Favier J, Tenenbaum F; et al. (2014). "Peritoneal implantation of pheochromocytoma following tumor capsule rupture during surgery". J Clin Endocrinol Metab. 99 (12): E2681–5. doi:10.1210/jc.2014-1975. PMID 25188716.
↑ Flávio Rocha M, Faramarzi-Roques R, Tauzin-Fin P, Vallee V, Leitao de Vasconcelos PR, Ballanger P (2004). "Laparoscopic surgery for pheochromocytoma". Eur Urol. 45 (2): 226–32. PMID 14734011.