肝腫瘍と鑑別を要した褐色細胞腫の1例

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  • A CASE OF PHEOCHROMOCYTOMA MIMICKING A GIANT LIVER TUMOR

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This paper presents a case of pheochromocytoma mimicking a giant liver tumor. A 50-year-old woman complaining of backpain was admitted to the hospital because of a large liver tumor detected by an abdominal CT scan at another hospital. She had no previous history of hypertension. However, episodes of an increase in the arterial blood pressure were encoutered during abdominal angiography and endoscopic retrograde cholangiography, suggesting that the tumor might be pheochromocytoma. Hormonal examinations performed subsequently to imaging tests confirmed the diagnosis. She underwent a laparotomy and the tumor being located in the retroperitoneal space adjacent to the upper pole of the right adrenal gland was removed. Microscopic appearance was consistent with that of pheochromocytoma. Furthermore, the tumor was considerd potentially malignant because of venous involvement seen in places. In areview of the literature it is clarified reported that nealy 10% of pheochromocytomas occur in extra-adreal regions such as in the paraaortic region, thoracic cavity, and urinary bladder. However, it is very rare that these pheochromocytomas in ectopic-origin mimic liver tumors. The present case lacked in clinical symptoms, but we were able to make preoperative diagnosis based on episodes of increase in arterial blood pressure at examinations, endocrinologic findings, careful imaging procedures, with consequent removal of the tumor.

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