Laparoscopic large adrenal mass resection: why we should be more careful?

Abstract

Abstract Background Pheochromocytoma is a rare tumor originating from the adrenal medulla, and surgical removal is the main treatment. We report a case of large size pheochromocytoma that was removed laparoscopically without preoperative blockade of alfa adrenergic receptors. Case presentation A 58-y-old woman was referred to our center with incidentally found 7 cm right adrenal mass. She did not have any history of hypercatecholamine state, and 24 h urine test for catecholamine metabolites was in normal range; we thought there is no need for preoperative catecholamine blockade. She was scheduled for laparoscopic mass resection, and during the operation, there was no significant bleeding and no major hypertension or hypotension crisis. The final pathology report was pheochromocytoma. Conclusion As the catecholamine release of pheochromocytoma may be periodic and inconsistent, the preoperative test should be repeated especially for large adrenal tumors.

Keywords

• Pheochromocytoma
• Laparoscopy
• Catecholamine blockade