Multicentric pheochromocytoma and involvement of the inferior vena cava

CONTEXT: Extension of pheochromocytomas to the inferior vena cava is rare. Multicentric tumors are rare as well, being present in up to 10% of cases. Surgery is the treatment of choice because of the long-term survival free of disease. DESIGN: Case report. CASE REPORT: We report on a case of right adrenal pheochromocytoma with extension to the supra-diaphragmatic vena cava, which underwent surgical excision through thoracophrenic laparotomy without the need for cardiopulmonary bypass. In a 6-year follow-up, another pheochromocytoma was found in the infra-renal Zuckerkandl's organ. Complete surgical excision of the tumor was performed by a median laparotomy and complete retroperitoneal dissection. In both cases, the total removal of the pheochromocytoma has been guaranteed by having margins free of tumor and a normal post-operative level of catecholamines. The pathological study revealed a malignant pheochromocytoma with margins free of neoplasia in both specimens

Multicentric pheochromocytoma and involvement of the inferior vena cava

CONTEXT: Extension of pheochromocytomas to the inferior vena cava is rare. Multicentric tumors are rare as well, being present in up to 10% of cases. Surgery is the treatment of choice because of the long-term survival free of disease. DESIGN: Case report. CASE REPORT: We report on a case of right adrenal pheochromocytoma with extension to the supra-diaphragmatic vena cava, which underwent surgical excision through thoracophrenic laparotomy without the need for cardiopulmonary bypass. In a 6-year follow-up, another pheochromocytoma was found in the infra-renal Zuckerkandl's organ. Complete surgical excision of the tumor was performed by a median laparotomy and complete retroperitoneal dissection. In both cases, the total removal of the pheochromocytoma has been guaranteed by having margins free of tumor and a normal post-operative level of catecholamines. The pathological study revealed a malignant pheochromocytoma with margins free of neoplasia in both specimens

Tratamento endovascular da síndrome da aorta média causada por arterite de Takayasu: relato de caso Endovascular treatment of the middle aortic syndrome due to Takayasu’s arteritis: case report

Síndrome da aorta média (SAM) é uma condição clínica caracterizada por estenose segmentar ou difusa da aorta, hipertensão arterial e claudicação de membros inferiores. A principal causa da SAM é a arterite de Takayasu. A estenose segmentar pode estar localizada na aorta suprarrenal, renal ou infrarrenal e com alta propensão de lesões estenóticas concomitantes das artérias renais e viscerais. A gravidade da hipertensão arterial é a principal indicação para o tratmento. A técnica endovascular para o tratamento da síndrome da aorta média tem bons resultados e é a menos invasiva. No presente artigo, é descrito o tratamento com sucesso de uma estenose da aorta toracoabdominal com recanalização da artéria mesentérica superior através de angioplastia em uma mulher de 34 anos portadora de arterite de Takayasu e hipertensão arterial grave.<br>Middle aortic syndrome (MAS) is a clinical condition characterized by segmental or diffuse narrowing of the aorta, hypertension, and lower limb claudication. The main cause of MAS is Takayasu’s arteritis. Segmental aortic stenosis may be located at the suprarenal, renal or infrarenal aorta with high tendency to concomitant stenosis in both the renal and visceral arteries. Severity of hypertension is the primary indication for intervention. Endovascular therapy is a minimally invasive treatment for MAS and may provide good results. In the present report, we describe a successful endovascular treatment of stenosis of the thoracoabdominal aorta with recanalization of the superior mesenteric artery using angioplasty in a 34-year-old woman with Takaysu’s arteritis and severe hypertension