Successful surgical treatment for life threatening metastatic thoracic and cervical pheochromocytoma

A 53 year-old woman had been followed up since 1996 after receiving bilateral adrenalectomy for the treatment of bilateral adrenal pheochromocytoma in von Hippel-Lindau (VHL) disease. In March 2003, she suffered from cough, dizziness and faint, and was referred to our hospital. The radiographic findings exhibited the presence of hypervascular tumors in the left hilum, left apex of the lung and the left neck. Tumor progression was suspected to occlude the left main pulmonary artery and hormonal assays showed elevated levels of the plasma norepinephrine, which may cause fatal complications. Percutaneous needle biopsy of the left cervical tumor revealed metastatic pheochromocytoma. After embolization of the main feeding artery, surgical resection of the tumor resulted in control of excess catecholamine release and symptoms.