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Adrenocortical carcinomas are rare but aggressive tumors that are frequently discovered as incidentalomas. Secretory tumors often lead to endocrine abnormalities, namely cushingoid features, virilization, or feminization. Non-functioning tumors, on the other hand, can be completely dormant with an insidious course or cause malaise, weight loss, abdominal pain, etc.

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Robotic-assisted excision of left para-aortic paraganglioma: a novel approach.

J Surg Case Rep

January 2025

Department of Endocrine Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne NE1 4LP, United Kingdom.

Paragangliomas, a type of extra-adrenal tumour, albeit rare, are dangerous due to their high metastatic potential and risk of hypertensive crisis from massive catecholamine release. It typically presents with sympathetic overdrive symptoms such as diaphoresis, headache, and palpitation, accompanied by substantially high plasma metanephrines level and mass on contrasted computed tomography abdomen and pelvis, whilst some are found incidentally. In this report, we discuss a case of an extra-adrenal lesion located near susceptible major structures with extensive vascularisation, in a patient with near-death experience.

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Background: The coexistence of pheochromocytoma and hyperaldosteronism is a rare and clinically significant finding with diagnostic challenges that need to be considered in the workup of patients with hypertension.

Case Presentation: This case report describes a 47-year-old Iranian man who initially presented with cold symptoms, chills, and headaches. Despite being diagnosed with panic disorder, his symptoms worsened, leading to a systolic blood pressure crisis.

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Pheochromocytoma is a catecholamine-secreting tumor that arises from the medullary chromaffin cells but can rarely be extra-adrenal in origin. We present a case of a 16-year-old female patient with uncontrolled hypertension, despite being on lisinopril and metoprolol, and associated left-sided chest pain, recurrent headaches, and an unintentional weight loss of 10 pounds in one month. Laboratory work-up showed a markedly elevated plasma metanephrine level of 4463.

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Background: Pheochromocytoma is a rare neuroendocrine tumor, and bilateral pheochromocytomas is even less common. Due to the limited experience with such cases, this study aims to explore the optimal surgical strategy, assess the potential advantages of robotic surgery, and evaluate surgical outcomes for managing bilateral pheochromocytomas.

Case Description: This report presented a case of a 33-year-old woman with bilateral pheochromocytomas related to multiple endocrine neoplasia type 2a (MEN2A), who was successfully managed by synchronous transperitoneal robotic-assisted bilateral cortical-sparing adrenalectomy.

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