嚢胞性変化を伴った副腎外褐色細胞腫の1例

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  • A CASE OF EXTRA-ADRENAL PHEOCHROMOCYTOMA ACCOMPANIED BY CYSTIC DEGENERATION

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We report herein a case of extra-adrenal pheochromocytoma accompanied by cystic degeneration, located at the inferior para-aortic region.<br> A 68-year-old man was admitted to the hospital for evaluation of an abdominal mass in the left upper quadrant. Ultrasonography and computed tomography of the abdomen revealed a large cystic mass with thick capsule and septum. Transverse T2-weighted magnetic resonance images of the abdomen showed a high signal intensity of the mass. Angiography revealed a thin stained tumor, fed by branches from the lumbar artery. Upon surgery, an extra-adrenal pheochromocytoma was suspected because acute hypertensive crisis was induced by manipulation of the tumor. In hormonal examinations of samples collected during the operation, catecholamine levels in both plasma and urine elevated. The resected specimen was an encapsulated tumor, 10×7.5×7cm in size, weighing 280g. In the section, a cystic formation with septum was noted. Histologically, the tumor was diagnosed as pheochromocytoma. The patient died of lung cancer a year after the operation. Reports of extra-adrenal pheochromocytoma accompanied by marked cystic degeneration are extremely rare, and only 3 cases, including this one, have been reported in Japan.

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