Challenges for endocrine surgeons: management of a colossal normotensive pheochromocytoma

Zahir Hussain, Jabamalai Ferdinant, Senthilkumar M. S., Kumaran M. P., Saivishnupriya V.


Although the presentation of pheochromocytoma is remarkably protean, it usually presents as sustained or paroxysmal hypertension with triad of headache, palpitation and diaphoresis. The Incidence of serendipitously discovered pheochromocytoma is approximately 4% to 8%. Perioperative management of such cases are not only controversial but also poses infallible challenges to the surgeon. This case report intends to highlight an unusual presentation of asymptomatic, normotensive pheochromocytoma as a huge abdominal mass and its management.


Asymptomatic, Perioperative management, Pheochromocytoma, Normotensive

Full Text:



Chen H, Sippel RS, O’Dorisio MS,Vinik AI, Lloyd RV, Pacak K. The North American Neuroendocrine TumorSociety consensus guideline for the diagnosis and management of neuroendocrinetumors: pheochromocytoma, paraganglioma, and medullary thyroidcancer. Pancreas. 2010;39(6):775-83.

Kopetschke R, Slisko M, Kilisli A,Tuschy U, Wallaschofski H, Fassnacht M, et al. Frequent incidental discovery of phaeochromocytoma:data from a German cohort of 201 phaeochromocytoma. Eur J Endocrinol. 2009;161(2):355-61.

Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR. The clinically inapparent adrenal mass: updatein diagnosis and management. Endocr Rev. 2004;25(2):309-40.

Agarwal A, Gupta S, Mishra AK, Singh N, Mishra SK. Normotensive pheochromocytoma: institutional experience. World J Surg. 2005;29(9):1185-8.

Shao Y, Chen R, Shen ZJ, Teng Y, Huang P, Rui WB, et al. Preoperative alpha blockade for normotensive pheochromocytoma: is it necessary? J Hypertens. 2011; 29(12):2429-32.

Basso L, Lepre L, Melillo M, Fora F, Mingazzini PL, Tocchi A. Giant pheochromocytoma: case report. Ir J Med Sci. 1996;165(1):57-9.

Arcos CT, Luque VR, Luque JA, Gracia PM, Jimenez AB, Munoz MM. Malignant giant pheochromocytoma: a case report and review of the literature. Can Urol Assoc J. 2009;3(6):E89-91.

Reisch N, Peczkowska M, Januszewicz A, Neumann H. Pheochromocytoma: presentation diagnosis and treatment. J Hypertens. 2006;24(12):2331-9.