Abstract
Pheochromocytoma is a rare catecholamine-secreting tumor derived from chromaffin cells.
The diagnosis is usually suggested by its classic history, presence of a strong family
history, or discovery of an incidental mass on imaging in an asymptomatic patient.
Hemorrhage into an occult pheochromocytoma is a rare complication with ∼1 to 2 per
100,000 individuals diagnosed annually. We report a case of a 29-year-old woman, who
presented with abdominal pain (with no other significant history) due to a right hemorrhagic
pheochromocytoma. Computed tomographic imaging and magnetic resonance imaging revealed
the source of retroperitoneal hemorrhage as the right adrenal mass. They lacked the
typical features of a pheochromocytoma which was eventually proven by the biochemical
tests. The patient underwent preoperative stabilization with α and β adrenergic receptor
blockers for 7 days following which laparoscopic adrenalectomy was performed successfully
with an uneventful postoperative period. This is the eighth reported case in literature
managed laparoscopically. Histopathology confirmed it as pheochromocytoma. The treacherous
and deceptive nature of pheochromocytomas and its hemorrhage make it crucial to detect
and treat it promptly; otherwise, it will almost certainly be fatal from cardiovascular
complications or metastasis.
Keywords
hemorrhagic pheochromocytoma - minimally invasive surgery - rare complication - case
report
