Transperitoneal laparoscopic adrenalectomy for a large pheochromocytoma: case report and review of the literature

Background: Laparoscopic adrenalectomy is the standard procedure for the removal of adrenal masses. Transperitoneal laparoscopic resection of adrenal tumor is the preferred surgical technique. In the present case report authors described a case with a 20 cm right pheochromocytoma successfully treated by using transperitoneal laparoscopic approach. Methods: A 26-year old man had a 20 cm retroperitoneal mass that was revealed by a contrast enhanced computed tomography and his preoperative blood epinephrine level was 421.41 pg/ml(normal range, <100 pg/ml). The patient was suspected to have a pheochromocytoma and received preoperative treatment with alpha-receptor blocker terazosin. A 20 cm retroperitoneal mass was successfully removed by transperitoneal laparoscopic approach. Results: The operative time was 180 min and blood loss was 100 ml. No intraoperative or postoperative complications developed in the patient. Pheochromocytoma of right adrenal gland was confirmed by histopathology. Conclusions: This case report suggests that adrenal tumor up to 20 cm in size may be treated by transperitoneal laparoscopic approach without complications. The experience and sufficient preoperative preparation are important for the success of the procedure.