Laparoscopic Vena Cava Thrombectomy and Radical Nephrectomy in a Malignant Pheochromocytoma Case

Tito Palmela Leitão; Miguel Miranda; Tiago Oliveira; Pedro Oliveira; Inês Pereira Pereira; José Palma dos Reis; Isabel Fernandes; Lucindo Ormonde; Luis Costa; Luis Mendes Pedro; Tomé Lopes

doi:10.24915/aup.37.1-2.162

Authors

Tito Palmela Leitão Univerdade de Lisboa - Faculdade de Medicina http://orcid.org/0000-0002-0075-6196
Miguel Miranda Centro Hospitalar Universitário Lisboa Norte https://orcid.org/0000-0002-5179-4491
Tiago Oliveira Centro Hospitalar Universitário Lisboa Norte http://orcid.org/0000-0003-3196-1886
Pedro Oliveira Centro Hospitalar Universitário Lisboa Norte
Inês Pereira Pereira Centro Hospitalar Universitário Lisboa Norte
José Palma dos Reis Univerdade de Lisboa - Faculdade de Medicina
Isabel Fernandes Univerdade de Lisboa - Faculdade de Medicina
Lucindo Ormonde Univerdade de Lisboa - Faculdade de Medicina
Luis Costa Univerdade de Lisboa - Faculdade de Medicina https://orcid.org/0000-0002-4782-7318
Luis Mendes Pedro Univerdade de Lisboa - Faculdade de Medicina
Tomé Lopes Univerdade de Lisboa - Faculdade de Medicina

DOI:

https://doi.org/10.24915/aup.37.1-2.162

Keywords:

Pheochromocytoma, Laparoscopy, Nephrectomy, Robotic Surgical Procedures, Thrombectomy, Vena Cava, Inferior

Abstract

Pheochromocytomas with vena cava thrombus are extremely rare, with only a few cases reported in the literature. Radical nephrectomy with adrenalectomy and inferior vena cava (IVC) thrombectomy is the treatment of choice. However, it is a challenging procedure and its surgical approach is yet to be standardized. We present a case of a 49-year-old male incidentally diagnosed with a pheochromocytoma with aggressive local invasion and a level 1 vena cava thrombus. A laparoscopic right radical nephrectomy with right adrenalectomy, IVC thrombectomy and cavorraphy. A detailed revision of the technique is performed and compared with current strategies for pheochromocytoma optimal treatment. Renal and adrenal masses with vena cava thrombus are associated with high morbidity and mortality, particularly in the case of pheochromocytoma. The management is complex but minimally invasive surgery can be performed safely in the context of an experienced multidisciplinary team.

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Author Biography

Tito Palmela Leitão, Univerdade de Lisboa - Faculdade de Medicina

Urology

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