Nonfunctioning Huge Malignant Pheochromocytoma with Liver Metastasis

ABSTRACT

A 27-year-old woman with a 4-month history of right upper quadrant dull pain and normal blood pressure was admitted in May 2001. Abdominal ultrasonography and abdominal computed tomography revealed a huge retroperitoneal mass with hepatic nodules. Histologic diagnosis was paraganglioma based on gun biopsy. Hormonal study for pheochromocytoma was negative. I-metaiodobenzylguanidine (MIBG) scintigraphy and angiography were performed for operation. The tumor was removed en bloc with part of the pancreas, spleen and hepatic mass. Pathologic examination with immunohistochemical staining revealed a malignant pheochromocytoma growing exophytically from the left adrenal and metastasizing to the liver. The postoperative course has been uneventful and no recurrence has been noted over a 2-months follow-up period.