Radiation Treatment of Recurrent Pheochromocytoma of the Bladder

Abstract

Secondary to the paucity of pheochromocytoma, very limited data exist regarding the optimal treatments of metastatic disease. Malignant pheochromocytomas are often considered unresponsive to radiotherapy, but this decision is based on the few case reports performed before 1970. There have been a handful of reports about metastatic resolution and palliation from radiation therapy. Nevertheless, radiotherapy is not considered a mainstay of pheochromocytoma treatment. In this case report, we describe a patient with a malignant extraadrenal pheochromocytoma, metastatic to the right humerus, and her treatment course of surgery and radiotherapy.

Endoprosthetic reconstruction for metastatic phaeochromocytoma in the distal femur: A case report

“…3,7 External beam irradiation is recommended as adjuvant therapy for bone metastasis following surgery. 4 Our patient also received external beam radiation therapy post-operatively. The prognosis of malignant phaeochromocytoma with multiple metastases is poor with 5 year survival rate of 30-60%.…”

“…3 Skeletal metastasis is often multiple, but solitary metastases although rare has been reported in rib, spine, ilium, mandible, humerus and proximal femur. 3,4,[8][9][10] Our case was unique that the metastasis presented 16 years after excision of primary abdominal tumor with a solitary lesion in the distal femur, which has until now not been reported in literature to our knowledge.…”

“…The patient with metastasis to proximal femur underwent disarticulation of the hip and the other with metastasis to proximal humerus underwent tumor extirpation and fibula graft reconstruction. 3,4 Solitary metastasis is recommended to be treated by surgical resection to control local and systemic consequences. 3,14 Surgery in malignant phaeochromocytoma may not be curative, however it reduces hormonal ill effects of the tumor and improves quality of life.…”

“…4,10 Patients with unresectable metastatic disease and sufficient uptake of MIBG are good candidates for radiometabolic treatment. 1 Chemotherapy is reserved for patients with unresectable lesions resistant to radio-ablation.…”

“…2 Its presentation as a solitary metastatic lesion in the long bones is extremely rare and there is paucity of literature regarding management of such cases. 3,4 We report one such case of malignant phaeochromocytoma presenting 16 years after excision of primary tumor. This patient had a solitary metastatic lesion in the left distal femur.…”