A Case of Asymptomatic Extra-adrenal Pheochromocytoma Associated with Rectal Cancer

Masaru Sakusabe¹⁾, Hiroshi Yoshioka¹⁾, Makoto Niwa¹⁾, Hitoshi Kotanagi²⁾, Yoshihiro Asanuma²⁾ and Akihiro Sugita³⁾

Department of Surgery, Yokote Municipal Hospital¹⁾
First Department of Surgery²⁾ and Second Department of Pathology³⁾,
Akita University School of Medicine

There has been few reports of gastrointestinal carcinoma associated with pheochromocytoma. We report a case with rectal cancer complicated by asymptomatic extra-adrenal pheochromocytoma. The patient, a 60-year-old female, suffering from lower abdominal pain and impaired bowel movement was diagnosed as rectal cancer based on findings of colonoscopy and barium enema. A preoperative abdominal CT revealed a para-aortic mass, located at the branch of the inferior mesenteric artery, and it was diagnosed as a lymph-node metastasis. At surgery, significant hypertension occurred while the para-aortic tumor was being resected, and followed by hypotension after resection. Postoperative histopathological studies were consistent with rectal cancer and extra-adrenal pheochromocytoma. Without adequate pre- and intraoperative blood-pressure management and infusion therapy, pheochromocytoma may be fetal in some cases. Since a para-aortic mass in patients with rectal cancer is not always a lymph-node metastasis, the tumor size and location, as well as any enlargement of the Group-1 lymph nodes, should be evaluated to determine other possible causes of the mass.

Key words
extra-adrenal pheochromocytoma, rectal cancer

Reprint requests
Masaru Sakusabe Department of Surgery, Akita Red Cross Hospital 222-1 Naeshirosawa-aza Saruta, Kamikitade, Akita-City, 010-1495 JAPAN

Accepted
April 26, 2000

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