Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease

Pheochromocytoma is one of recurrent tumors in patients with von Hippel-Lindau (VHL) disease. For patients with bilateral adrenal glands, unilateral adrenalectomy is the treatment of choice; however, for patients with a single adrenal gland, hemiadrenalectomy or tumorectomy can be performed instead...

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Main Author: Byung Kwan Park
Format: Article
Language:English
Published: Sungkyunkwan University School of Medi 2023-06-01
Series:Precision and Future Medicine
Subjects:
Online Access:http://pfmjournal.org/upload/pdf/pfm-2023-00058.pdf
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author Byung Kwan Park
author_facet Byung Kwan Park
author_sort Byung Kwan Park
collection DOAJ
description Pheochromocytoma is one of recurrent tumors in patients with von Hippel-Lindau (VHL) disease. For patients with bilateral adrenal glands, unilateral adrenalectomy is the treatment of choice; however, for patients with a single adrenal gland, hemiadrenalectomy or tumorectomy can be performed instead of adrenalectomy to preserve adrenal function. Currently, adrenalectomy is recommended even if recurrent pheochromocytomas occur in the residual adrenal tissue. Consequently, adrenal insufficiency cannot be avoided in these patients. Percutaneous radiofrequency ablation (RFA) is used as an alternative treatment for preserving adrenal function; however, RFA is difficult to perform when major organs are present in the approaching pathway. The trans-hepatic approach is the only reported safe route to approach a right adrenal tumor to avoid pneumothorax. In this case report, we performed percutaneous RFA and hydrodissection through the left renal parenchyma to treat a recurrent pheochromocytoma in the small residual left adrenal tissue, which is surrounded by several critical organs. Our goal was to show our experience of image-guided trans-renal RFA and hydrodissection in a patient with VHL disease.
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spelling doaj.art-e5f0a21a5aa34fc2a2b22cbd6a10f7582023-07-07T04:26:26ZengSungkyunkwan University School of MediPrecision and Future Medicine2508-79402508-79592023-06-0172909310.23838/pfm.2023.00058147Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau diseaseByung Kwan Park0 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaPheochromocytoma is one of recurrent tumors in patients with von Hippel-Lindau (VHL) disease. For patients with bilateral adrenal glands, unilateral adrenalectomy is the treatment of choice; however, for patients with a single adrenal gland, hemiadrenalectomy or tumorectomy can be performed instead of adrenalectomy to preserve adrenal function. Currently, adrenalectomy is recommended even if recurrent pheochromocytomas occur in the residual adrenal tissue. Consequently, adrenal insufficiency cannot be avoided in these patients. Percutaneous radiofrequency ablation (RFA) is used as an alternative treatment for preserving adrenal function; however, RFA is difficult to perform when major organs are present in the approaching pathway. The trans-hepatic approach is the only reported safe route to approach a right adrenal tumor to avoid pneumothorax. In this case report, we performed percutaneous RFA and hydrodissection through the left renal parenchyma to treat a recurrent pheochromocytoma in the small residual left adrenal tissue, which is surrounded by several critical organs. Our goal was to show our experience of image-guided trans-renal RFA and hydrodissection in a patient with VHL disease.http://pfmjournal.org/upload/pdf/pfm-2023-00058.pdfhumans pheochromocytomaradiofrequency ablationvon hippel-lindau disease
spellingShingle Byung Kwan Park
Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease
Precision and Future Medicine
humans pheochromocytoma
radiofrequency ablation
von hippel-lindau disease
title Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease
title_full Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease
title_fullStr Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease
title_full_unstemmed Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease
title_short Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease
title_sort case report of trans renal ablation procedures for a recurrent pheochromocytoma in von hippel lindau disease
topic humans pheochromocytoma
radiofrequency ablation
von hippel-lindau disease
url http://pfmjournal.org/upload/pdf/pfm-2023-00058.pdf
work_keys_str_mv AT byungkwanpark casereportoftransrenalablationproceduresforarecurrentpheochromocytomainvonhippellindaudisease