High incidence of morbidity following resection of metastatic pheochromocytoma in the spine: Report of 5 cases

Paul E. Kaloostian*, Patricia L. Zadnik, Jennifer E. Kim, Mari L. Groves, Jean Paul Wolinsky, Ziya L. Gokaslan, Timothy F. Witham, Ali Bydon, Daniel M. Sciubba

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Pheochromocytomas of the spine are uncommon and require careful preoperative planning. The authors retrospectively reviewed the charts of 5 patients with metastatic spinal pheochromocytoma who had undergone surgical treatment over the past 10 years at their medical center. They reviewed patient age, history of pheochromocytoma resection, extent and location of metastases, history of alpha blockage, surgical level, surgical procedure, postoperative complications, tumor recurrence, and survival. Metastases involved the cervical (1 patient), thoracic (3 patients), and lumbar (2 patients) levels. Preoperative treatment included primary pheochromocytoma resection, chemotherapy, alpha blockade, embolization, and radiation. Three patients had tumor recurrence, and 2 underwent 2-stage reoperations for tumor extension. Hemodynamic complications were common: 2 patients developed pulseless electrical activity arrest within 4 months after surgery, 1 patient had profound postoperative tachycardia with fever and an elevated creatine kinase level, and 1 patient experienced transient postoperative hypotension and paraplegia. One patient died of complications related to disseminated cerebral and spinal disease. With careful preoperative and surgical management, patients with symptomatic metastatic spinal pheochromocytoma can benefit from aggressive surgical treatment. Postoperative cardiovascular complications are common even months after surgery, and patients should be closely monitored long term.

Original languageEnglish (US)
Pages (from-to)726-733
Number of pages8
JournalJournal of Neurosurgery: Spine
Volume20
Issue number6
DOIs
StatePublished - Jun 2014

Keywords

  • En bloc
  • Oncology
  • Spinal pheochromocytoma
  • Spinal tumor

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

Fingerprint Dive into the research topics of 'High incidence of morbidity following resection of metastatic pheochromocytoma in the spine: Report of 5 cases'. Together they form a unique fingerprint.

  • Cite this

    Kaloostian, P. E., Zadnik, P. L., Kim, J. E., Groves, M. L., Wolinsky, J. P., Gokaslan, Z. L., Witham, T. F., Bydon, A., & Sciubba, D. M. (2014). High incidence of morbidity following resection of metastatic pheochromocytoma in the spine: Report of 5 cases. Journal of Neurosurgery: Spine, 20(6), 726-733. https://doi.org/10.3171/2014.3.SPINE13535