20% of pheochromocytomas is associated with von Hippel-Lindau disease. PCC occur in 7–20% of families with VHL
Located in the adrenal gland. Maybe sporadic, or as part of a familial syndrome (von Hippel-Lindau disease, MEN 2A & 2B, & neurofibromatosis). Consider genetic testing if age at diagnosis is < 50 years for mutations of VHL and other genetic abnormalities (RET, SDHS, SDHB, SDHC 1)).
A pheochromocytoma (from Greek phaios “dark”, chroma “color”, kytos “cell”, -oma “tumor”) or phaeochromocytoma (PCC) is a neuroendocrine tumor of the medulla of the adrenal glands (originating in the chromaffin cells), or extra-adrenal chromaffin tissue that failed to involute after birth and secretes high amounts of catecholamines, mostly norepinephrine, plus epinephrine to a lesser extent.
Extra-adrenal paragangliomas (often described as extra-adrenal pheochromocytomas) are closely related, though less common, tumors that originate in the ganglia of the sympathetic nervous system and are named based upon the primary anatomical site of origin.
A unique case of metastatic pheochromocytoma of the cervical spine treated with preoperative embolization and subsequent en bloc resection. A 65-year-old man with metastatic pheochromocytoma presented with two weeks of worsening neck pain, left arm and leg weakness and paresthesia, and urinary incontinence. Magnetic resonance imaging showed a metastatic osseous lesion at C6 with severe stenosis and spinal cord compression. The patient underwent successful preoperative angiographic embolization with a liquid embolic agent followed by C5-C7 laminectomy, en bloc tumor resection, and C3-T2 posterior spinal fusion. Six weeks postoperatively, the patient reported improving strength and resolving neck pain and paresthesias. While there is no standard paradigm for the treatment of metastatic pheochromocytomas of the cervical spine, preoperative embolization may minimize intraoperative blood loss and hemodynamic instability during subsequent surgical resection 2).