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A large pheochromocytoma requiring aortic and inferior vena caval reconstruction: A case report
Jian Wang1, Ding Yuan2, Ya Lu3
1Department of Vascular Surgery, The West China Medical School of Sichuan University, West China Hospital of Sichuan University, Chengdu, Sichuan.
Rationale:
It is difficult to discriminate malignant pheochromocytoma (PCC) from benign PCC. The requirement of abdominal aortic and inferior vena cava reconstruction is extremely rare.
Patient Concerns:
We here report a case of a large pheochromocytoma in a 56-year-old woman who complained of only hand trembling and had no hypertension or other symptoms. The operation was difficult because of a tight adhesion to the circumference of great vessels. A replacement of the aortocaval vessels with grafts was necessary to remove the tumor completely.
Diagnoses:
Ultrasonography, computed tomography (CT), and catecholamine assay revealed suspecting the retroperitoneal PCC.
Interventions:
Tumor excision and reconstruction of the abdominal aorta and inferior vena cava by externally supported polytetrafluoroethylene (ePTFE) vessels were successfully performed.
Outcomes:
A follow-up CT angiography showed no recurrence and graft vessels presented good patency after 7years. Catecholamine in urine and serum assay was normal.
Lessons:
The complete resection of the tumor and infiltrated great vessels were necessary for the long-term survival of patients with a large PCC. The ePTFE graft is a good substitute for vessel reconstruction.
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