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Preoperative embolization followed by surgical excision of an intrapericardial pheochromocytoma
Ased M Ali1, Mohan Devbhandari, Anand Sastry
1Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester, United Kingdom.
Insights
A rare intrapericardial pheochromocytoma in a teenager was successfully treated with preoperative embolization and surgery. This interventional radiology and surgical approach minimized bleeding and ensured a quick recovery.
Area of Science:
- Cardiology
- Interventional Radiology
- Surgical Oncology
Background:
- Pheochromocytomas are rare neuroendocrine tumors that can occur in various locations.
- Intrapericardial pheochromocytomas are exceptionally rare, presenting unique diagnostic and therapeutic challenges.
Observation:
- A teenage patient presented with palpitations and hypertension, indicative of a catecholamine-secreting tumor.
- Imaging revealed an intrapericardial pheochromocytoma arising from the left atrium with extensive collateral blood supply.
Findings:
- Preoperative radiologic embolization of the major feeding arteries significantly reduced tumor vascularity.
- Surgical resection via median sternotomy and cardiopulmonary bypass was performed with minimal intraoperative bleeding.
Implications:
- This case highlights the successful multidisciplinary management of a rare intrapericardial pheochromocytoma.
- Preoperative embolization is a valuable strategy to control vascularity and facilitate surgical resection of such tumors.
Abstract:
A teenager with palpitations and hypertension was found to have an intrapericardial pheochromocytoma of the left atrium with multiple feeding collaterals. Radiologic embolization was carried out on the major feeding arteries to the tumor preoperatively with good angiographic result. Surgery was carried out the following day through a median sternotomy approach and cardiopulmonary bypass. Minimal bleeding was observed due to prior embolization. The patient made a rapid postoperative recovery and was discharged 7 days later.
