A case of malignant pheochromocytoma with cranial metastasis
10.3760/cma.j.cn311282-20190416-00151
- VernacularTitle:恶性嗜铬细胞瘤伴颅骨转移一例报道
- Author:
Xiaomeng JIA
1
;
Kang CHEN
;
Lina JIANG
;
Ping PANG
;
Lin WANG
;
Ling ZHAO
;
Xiaodong HU
;
Li ZANG
;
Jin DU
;
Weijun GU
;
Jianming BA
;
Guoqing YANG
;
Zhaohui LYU
;
Jingtao DOU
;
Yiming MU
Author Information
1. 中国人民解放军总医院第一医学中心内分泌科，北京 100853
- From:
Chinese Journal of Endocrinology and Metabolism
2020;36(5):425-428
- CountryChina
- Language:Chinese
-
Abstract:
This article reported a case of malignant pheochromocytoma and paraganglioma with cranial metastasis. The patient was a 25-year-old man. At the age of 10, he was diagnosed with retroperitoneal paraganglioma. He received radiotherapy after partial resection of the tumor. At the age of 15, when he consulted for headache and hypertension, a space occupying lesion was found on the right adrenal without further diagnosis and treatment. His headache and hypertension were aggravated at the age of 25. Then he visited our medical center and diagnosed with right adrenal pheochromocytoma. He undertook an operation to remove the right adrenal lesion, and his blood pressured could be controlled in the normal range with oral antihypertensive medication. One year after the surgery, a cranial lesion with positive 131I-metaiodobenzylguanidine imaging was found following the increase of norepinephrine and dopamine in both blood and urine. The diagnosis of malignant pheochromocytoma with cranial metastasis was confirmed. The cranial lesion was treated with cyberknife therapy for 4 times, and the lesion was slightly reduced. Four year after the removal of right adrenal tumor, he developed multiple bone metastasis in the right ribs and left ilium, and then he received 131I-metaiodobenzylguanidine radiotherapy. Additionally, the results of gene test indicated a pathogenic mutation of SDHB. During the follow-up period of one year after the treatment, his blood pressure fluctuated to about 140/90mmHg with 10mg of phenoxybenzamine once a day. The case is a malignant pheochromocytoma with multiple bone metastasis characterized by a long course with an ideal prognosis in a way. Consequently, we suggested the diagnostic pathway with genetic testing based on clinical phenotype to approach more timely diagnosis and reasonable evaluation of the prognosis in pheochromocytoma and paraganglioma. Furthermore, clinicians should pay more attention to the long-term surveillance.
