Computed Tomography-guided Percutaneous Cryoablation of Hereditary Adrenal Pheochromocytoma in Three Patients

Overview

Journal J Pediatr Endocrinol Metab

Specialties Endocrinology
Pediatrics

Date 2024 May 29

PMID 38807486

Authors

Emily Griffing

Brenton Reading

Francesco De Luca

Daniel Agne

David Juang

Kelsee Halpin

Affiliations

Soon will be listed here.

Abstract

Objectives: Pheochromocytomas (PHEO) are neuroendocrine tumors rarely diagnosed in children. We are reporting on the management challenges of three adolescent patients who present with hereditary PHEO.

Case Presentation: The index patient and his male sibling presented with bilateral PHEO, while a third patient presented with a unilateral PHEO, all associated with von Hippel-Lindau (VHL) syndrome. The patients were treated with computed tomography (CT)-guided percutaneous cryoablation (CRA) of the adrenal lesions, with varying degrees of success.

Conclusions: CT-guided percutaneous CRA of hereditary PHEO has not been reported in the pediatric population and may represent a novel treatment strategy that reduces the risk of intraprocedural complications and adrenal insufficiency (AI).

References

Lenders J, Duh Q, Eisenhofer G, Gimenez-Roqueplo A, Grebe S, Murad M . Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014; 99(6):1915-42. DOI: 10.1210/jc.2014-1498. View

Waguespack S, Rich T, Grubbs E, Ying A, Perrier N, Ayala-Ramirez M . A current review of the etiology, diagnosis, and treatment of pediatric pheochromocytoma and paraganglioma. J Clin Endocrinol Metab. 2010; 95(5):2023-37. DOI: 10.1210/jc.2009-2830. View

Park H, Kim M, Lee J, Kim J, Jeong B, Lee S . Clinical Presentation and Treatment Outcomes of Children and Adolescents With Pheochromocytoma and Paraganglioma in a Single Center in Korea. Front Endocrinol (Lausanne). 2021; 11:610746. PMC: 7879705. DOI: 10.3389/fendo.2020.610746. View

Pereira B, Nunes da Silva T, Bernardo A, Cesar R, Luiz H, Pacak K . A Clinical Roadmap to Investigate the Genetic Basis of Pediatric Pheochromocytoma: Which Genes Should Physicians Think About?. Int J Endocrinol. 2018; 2018:8470642. PMC: 5884154. DOI: 10.1155/2018/8470642. View

Bausch B, Wellner U, Bausch D, Schiavi F, Barontini M, Sanso G . Long-term prognosis of patients with pediatric pheochromocytoma. Endocr Relat Cancer. 2013; 21(1):17-25. DOI: 10.1530/ERC-13-0415. View

Aufforth R, Ramakant P, Sadowski S, Mehta A, Trebska-McGowan K, Nilubol N . Pheochromocytoma Screening Initiation and Frequency in von Hippel-Lindau Syndrome. J Clin Endocrinol Metab. 2015; 100(12):4498-504. PMC: 4667160. DOI: 10.1210/jc.2015-3045. View

Ierardi A, Carnevale A, Angileri S, Pellegrino F, Renzulli M, Golfieri R . Outcomes following minimally invasive imagine-guided percutaneous ablation of adrenal glands. Gland Surg. 2020; 9(3):859-866. PMC: 7347819. DOI: 10.21037/gs.2020.03.32. View

McBride J, Atwell T, Charboneau W, Young Jr W, Wass T, Callstrom M . Minimally invasive treatment of metastatic pheochromocytoma and paraganglioma: efficacy and safety of radiofrequency ablation and cryoablation therapy. J Vasc Interv Radiol. 2011; 22(9):1263-70. DOI: 10.1016/j.jvir.2011.06.016. View

Liu S, Chu C, Kong A, Wong S, Chiu P, Chow F . Radiofrequency ablation compared with laparoscopic adrenalectomy for aldosterone-producing adenoma. Br J Surg. 2016; 103(11):1476-86. DOI: 10.1002/bjs.10219. View

10.

Xie L, Qi H, Cao F, Shen L, Chen S, Wu Y . Comparison between surgery and thermal ablation for adrenal metastases: a retrospective study. Int J Hyperthermia. 2021; 38(1):1541-1547. DOI: 10.1080/02656736.2021.1993356. View

11.

Yamakado K . Image-guided ablation of adrenal lesions. Semin Intervent Radiol. 2014; 31(2):149-56. PMC: 4078140. DOI: 10.1055/s-0034-1373797. View

12.

Zhang W, Sun L, Xu J, Fu Y, Zhuang Z . Computed tomography-guided cryoablation for adrenal metastases: local control and survival. Medicine (Baltimore). 2018; 97(51):e13885. PMC: 6320079. DOI: 10.1097/MD.0000000000013885. View

13.

Ramachandran R, Rewari V . Current perioperative management of pheochromocytomas. Indian J Urol. 2017; 33(1):19-25. PMC: 5264186. DOI: 10.4103/0970-1591.194781. View

14.

Mazeh H, Weiss D, Peter M, Grozinsky-Glasberg S, Oleinikov K, Szalat A . Deliberate Compensated Vasoplegia-A Novel Pharmaceutical Approach for Controlling Blood Pressure During Surgery for Pheochromocytoma. World J Surg. 2023; 47(4):985-994. DOI: 10.1007/s00268-023-06894-w. View