Surgical resection of multiple liver metastasis of functional malignant pheochromocytoma: a case report and literature review.

Functional malignant pheochromocytoma is a rare tumor. Also, liver metastatic pheochromocytoma is deemed to be incurable because of its poor prognosis. Surgical debulking and removal of primary and metastases tumors, as well as radiosurgical or surgical treatment are recommended for patients. We treated a patient with multiple liver metastasis of functional malignant pheochromocytoma 4 years after the adrenal primary lesion was resected. The liver metastases were successfully removed by surgical resection. During the operation, the blood pressure increased quickly when the tumor was held between the fingers, reached the highest (201/110 mmHg), and then quickly declined to normal when the pressure was relieved. The patient is alive for more than 5 years after the operation. Thus, we believe that functional liver metastases of malignant pheochromocytoma may be curable by surgical resection with careful monitoring of anesthesia and blood pressure. Every effort should be taken to avoid direct stimulation of the tumor in the operation.