Malignant pheochromocytoma with IVC thrombus

Shigemura, Katsumi; Tanaka, Kazushi; Arakawa, Soichi; Hara, Isao; Kawabata, Gaku; Fujisawa, Masato

doi:10.1007/s11255-005-4969-4

Cited by 13 publications

(8 citation statements)

References 10 publications

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“…[3839] The simultaneous occurrence of pheochromocytoma and IVC thrombosis can be explained by (1) local compression leading to alteration in blood flow and stasis, (2) sustained hypertension leading to vascular endothelial injury and hypercoagulbility, (3) association of pheochromocytoma with systemic lupus erythematous and Behcet's disease might explain the triggering of an autoimmune phenomenon leading to aortoarteritis, and (4) An underlying anatomic abnormality or coagulation disorder. It also could be a chance association between these two conditions.…”

Section: Discussionmentioning

confidence: 99%

Coexistence of pheochromocytoma with uncommon vascular lesions

Kota

Meher

et al. 2012

Indian J Endocr Metab

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Background:Pheochromocytoma/paragangliomas have been described to be associated with rare vascular abnormalities like renal artery stenosis. Coexistence of physiologically significant renal artery lesions is a compounding factor that alters management and prognosis of pheochromocytoma patients. Apart from individual case reports, data on such association in Indian population is not available. The aim of this study is to find the nature and prevalence of associated vascular abnormalities.Materials and Methods:From 1990 to 2010, a total of 50 patients were diagnosed with pheochromocytoma/paragangliomas. Hospital charts of these patients were reviewed retrospectively to identify those with unusual vascular abnormalities. Available literature was also reviewed.Results:Of the 50 patients with pheochromocytoma, 7 (14%) had coexisting vascular lesions including renal artery stenosis in 4, aortoarteritis in 1, aortic aneurysm in 1 and inferior vena cava thrombosis in 1. Pheochromocytoma was adrenal in 42 and extra adrenal in 8. Laparoscopic adrenalectomy was done in the patients. One patient with renal artery stenosis due to intimal fibrosis was subjected to percutaneous balloon angioplasty; the other three improved after adrenalectomy and lysis of fibrous adhesive bands. The patient with aortoarteritos was treated with oral steroids. Inferior vena cava thrombosis was reversed with anticoagulants. The patient with abdominal aortic aneurysm was advised for annual follow-up on account of its size of 4.5 cm and asymptomatic presentation.Conclusion:There are multiple mechanisms that can lead to renal artery stenosis and other vascular abnormalities in a case of pheochromocytoma. A high index of suspicion is necessary to enable both entities to be diagnosed preoperatively and allow proper planning of surgical therapy. Incomplete diagnosis may lead to persistent hypertension postoperatively in a case of associated renal artery stenosis.

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Section: Discussionmentioning

confidence: 99%

Coexistence of pheochromocytoma with uncommon vascular lesions

Kota

Meher

et al. 2012

Indian J Endocr Metab

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“…Two aspects render our case unusual: 1) the coexistence of pheochromocytoma with IVC thrombosis 2) Though there are case reports citing the association between malignant pheochromocytoma and IVC thrombus,[78] to our sincere belief; this is the first such report citing this uncommon association from India.…”

Section: Discussionmentioning

confidence: 93%

Pheochromocytoma with inferior vena cava thrombosis: An unusual association

Kota

Jammula

et al. 2012

Journal of Cardiovascular Disease Research

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Pheochromocytomas have been described in association with vascular abnormalities like renal artery stenosis. A 48-year-old man was admitted to our hospital with the complaints of headache, sweating, anxiety, dizziness, nausea, vomiting and hypertension. For last several days, he was having a dull aching abdominal pain. Abdominal computed tomography (CT) revealed the presence of a left adrenal pheochromocytoma. An inferior vena cava (IVC) venogram via the right jugular vein demonstrated occlusion of the IVC inferior to the right atrium. Surgical removal of pheochromocytoma was done, followed by anticoagulant treatment for IVC thrombosis, initially with subcutaneous low molecular weight heparin, and then with oral warfarin, resulting in restoration of patency. To the best of our knowledge, the occurrence of pheochromocytoma in IVC thrombosis has not been reported so far from India. Possible mechanisms of such an involvement are discussed.

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“…Similarly, there was no IVC wall invasion intraoperatively in our case. There are few case reports of malignant adrenal and extra-adrenal pheochromocytoma associated with IVC thrombosis [17, 18]. …”

Section: Discussionmentioning

confidence: 99%

Marker-Negative Pheochromocytoma Associated with Inferior Vena Cava Thrombosis

Poudyal

Pradhan

Chapagain

et al. 2017

Case Reports in Urology

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Pheochromocytoma associated with inferior vena cava (IVC) thrombosis is very rare. A 27-year-old female presented with right flank pain and hypertensive urgency. Contrast-enhanced CT abdomen and gadolinium-contrast MRI abdomen revealed right adrenal mass suspicious of malignancy with invasion and compression to the right IVC wall along with IVC thrombus extending from the level of renal veins to the level of confluence with hepatic veins. Her routine laboratory investigations including 24-hour urine fractionated metanephrines, vanillylmandelic acid, and cortisol were normal. Right adrenalectomy with IVC thrombectomy was done. Perioperative period was uneventful. Histopathology of the mass turned out to be pheochromocytoma with thrombus revealing fibroadipose tissue with fibrin. Pheochromocytoma may present with IVC thrombus as well as normal serum and urinary markers. Thus, clinical suspicion is imperative in perioperative management of adrenal mass.

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Malignant pheochromocytoma with IVC thrombus

Cited by 13 publications

References 10 publications

Coexistence of pheochromocytoma with uncommon vascular lesions

Coexistence of pheochromocytoma with uncommon vascular lesions

Pheochromocytoma with inferior vena cava thrombosis: An unusual association

Marker-Negative Pheochromocytoma Associated with Inferior Vena Cava Thrombosis

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