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Intrapericardial pheochromocytoma.

C H Chang1, P J Lin, J P Chang

  • 1Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.

The Annals of Thoracic Surgery
|April 1, 1991
PubMed
Summary
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A rare intrapericardial pheochromocytoma in the left atrium was successfully resected in a hypertensive patient. This case highlights the importance of advanced imaging and surgical techniques for treating these challenging cardiac tumors.

Area of Science:

  • Cardiovascular Surgery
  • Endocrinology
  • Oncology

Background:

  • Intrapericardial pheochromocytomas are rare neuroendocrine tumors with significant diagnostic and therapeutic challenges.
  • Hypertension and elevated urinary catecholamines are key indicators, necessitating thorough investigation.

Observation:

  • A 34-year-old male with a 12-year history of hypertension and elevated urinary catecholamines presented with an intrapericardial pheochromocytoma located in the left atrium.
  • Diagnostic imaging, including meta-iodobenzylguanidine (m-[131I]iodobenzylguanidine) scans and chest computed tomography, precisely located the tumor.

Findings:

  • Surgical resection via left thoracotomy with cardiopulmonary bypass and circulatory arrest resulted in complete tumor removal.
  • Postoperative follow-up at 34 months showed normalization of blood pressure and urinary catecholamine levels.

Related Experiment Videos

  • Literature review of 15 cases indicated successful resection in most survivors, though residual disease and metastasis can occur.

    • Implications:

    • Meta-iodobenzylguanidine scans combined with computed tomography are crucial for accurate tumor localization.
    • Careful surgical planning, including the use of cardiopulmonary bypass, is essential for managing these highly vascular intrapericardial tumors.
    • Complete resection offers a favorable prognosis for patients with intrapericardial pheochromocytoma.