Giant Left Pheochromocytoma and its Innovative Therapeutic Paradigm

Author(s): Madathipat Unnikrishnan, Ramankutty Ramraj, Dathan Neetu S

Pheochromocytoma, rare tumour arising from chromaffin cells of suprarenal medulla presents with paroxysmal hypertension due to biochemical endocrine activity. Nevertheless, giant tumour is known to show endocrine inactivity. We describe 56-yr-old lady on antihypertensives who incidentally showed large suprarenal mass in abdominal ultrasonogram with no overt endocrine activity biochemically. Computed tomography scan showed well circumscribed left sided giant suprarenal tumour pushing left diaphragmatic dome upwards and left kidney downwards. Thoraco-phreno-laparotomy was employed instead of standard laparotomy for its safe and tidy removal. Tumour weighed 490 grams and histopathology confirmed benign pheochromocytoma. During follow-up at one year she remains asymptomatic.