Brain Metastasis of Pheochromocytoma: Diagnostic and Therapeutic Challenge

World Neurosurg. 2019 Oct:130:391-399. doi: 10.1016/j.wneu.2019.06.163. Epub 2019 Jun 28.

Abstract

Background: Pheochromocytoma brain metastasis is extremely rare. Few cases have been reported in the literature. Therefore, diagnosis and effective treatment of these lesions are difficult.

Case description: Here, we report the case of 29-year-old woman, who was operated on for a right adrenal pheochromocytoma. Fourteen months later, a posterior fossa tumor was diagnosed. Radiologic findings mimicked an extra-axial lesion. The radiologic differential diagnosis was difficult even using magnetic resonance imaging spectroscopy. The patient was operated on through a retrosigmoid approach. Local recurrence occurred 6 months after first surgery. The patient died 1 month later, despite a second operation.

Conclusions: Although the occurrence of brain metastases in pheochromocytoma is not prevalent, patients presenting with suggestive features need to be carefully considered. Magnetic resonance imaging can help in differential diagnosis with a primary brain tumor. There are no established guidelines for the treatment of pheochromocytoma brain metastasis, for which the prognosis remains dismal, despite effective surgery.

Keywords: Brain tumor; Metastasis; Pheochromocytoma; Surgery.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms*
  • Adult
  • Diagnosis, Differential
  • Fatal Outcome
  • Female
  • Humans
  • Infratentorial Neoplasms / pathology
  • Infratentorial Neoplasms / secondary*
  • Infratentorial Neoplasms / surgery
  • Magnetic Resonance Imaging
  • Pheochromocytoma / diagnosis
  • Pheochromocytoma / secondary*
  • Pheochromocytoma / surgery
  • Reoperation
  • Tomography, X-Ray Computed