Profitable therapy of malignant pheochromocytoma with sacrum metastases: A case report.
Drugs (Baltimore). 2018 Aug;97(35):e12184
Authors: Liu S, Zhou X, Music A, Li WA, Rastogi R, Wang Y, Liu Y
RATIONALE: Malignant pheochromocytoma within the backbone is a uncommon illness with out normal healing managements up to now. The target of this text is to report a really uncommon case of malignant pheochromocytoma with sacrum metastases inflicting extreme lumbosacral ache, which was introduced with acute radiculopathy and handled with three operations mixed with cement augmentation and stabilization. The administration of those distinctive circumstances has but to be well-documented.
PATIENT CONCERNS: A 58-year-old man introduced with lumbosacral ache, radiating ache and numbness of the best extremity. The affected person underwent excision of proper adrenal pheochromocytoma in 2010. Imaging research revealed the density of soppy tissues, apparent bony destruction within the sacrum, and vital spinal wire obstruction.
DIAGNOSES: We consider that is the primary report of malignant pheochromocytoma with sacrum metastases.
INTERVENTIONS: The affected person underwent tissue biopsy and osteoplasty after embolization of the interior iliac artery in January 2015, and exploratory surgical procedure, circumferential spinal wire decompression, and a stabilization process by way of a posterior strategy in June 2015 as a result of spinal canal stenosis attributable to cement. For the reason that place of pedicle screw was not adequate, a revision surgical procedure was carried out the subsequent day following the procedures in June 2015.
OUTCOMES: The affected person’s neurological deficits improved considerably after the third surgical procedure, and the postoperative interval was uneventful on the three-year follow-up go to.
LESSONS: We advocate the posterior strategy for spinal decompression of the metastatic pheochromocytoma when the tumor has brought on neurological deficits. Osteoplasty by cement augmentation can also be a good selection for surgical therapy. Nevertheless, the potential danger of problems in bone cement purposes have to be totally acknowledged.
PMID: 30170467 [PubMed – indexed for MEDLINE]