Malignant pheochromocytoma with cerebral and skull metastasis: A case report and literature review

Table 1 Summary of malignant pheochromocytomas with cerebral and/or skull metastasis

Ref.	Year	Age (yr)/sex	Symptoms and signs	Location	Surgery	Immunohistochemical presentation	Adjuvant treatment	Clinical outcome	Others
Spatt et al[10]	1948	51/F	Headaches, falls, poor memory, drowsiness and convulsions	Multiple lesions in peduncles, cerebellum, pons, and cerebrum	Right subtemporal decompression	NR	None	Died 8th day postadmission	NR
Melicow et al[11]	1977	61/M	Headaches, convulsions, sweating, palpitation and hypertension	NR	None	NR	None	Died 6th week postadmission	Metastases to liver and carcinoid of ileum
Ferrari et al[12]	1979	47/M	Progressive cognitive deterioration	Multiple lesions in frontal, parietal, temporal, and occipital lobes and cerebellum	None	NR	None	Died 22th day postadmission	NR
Grabel et al[13]	1990	43/F	Painless scalp mass	Left parietal lesion	Surgical resection	Chromogranin and neuro-specific enolase and negative for prekeratin	Preoperative chemotherapy	Relieved	NR
Mornex et al[14]	1992	49/M	NR	NR	NR	NR	None	Died after 8 yr	Lung, lymph node metastases
Gentile  et al[15]	2001	31/F	Partial motor crisis	Right frontal lesion	Surgical resection	Neuron-specific enolase, S100 protein and chromogranin; negative for anti-calcitonin	None	No relapse of disease in 4-yr follow-up	MEN type 2a
Liel et al[16]	2002	47/M	Radiographic surveillance	Right frontotemporal	Surgical resection	Chromogranin, negative for progesterone receptors and epithelial membrane antigen	Postoperative MIBG therapy	Relieved	Coexistence of recurrent meningioma in the left hemisphere
Mercuri et al[17]	2005	46/F	Headaches, vomiting, hypertension	Right temporoparietal extra-axial lesion with inner table skull infiltration. Epidural and subdural	Surgical resection	Neuron-specific enolase, chromogranin A, synaptophysin	None	No relapse of disease in 6-yr follow-up	First primary meningeal pheochromocytoma
Kowalska et al[18]	2009	60/F	Hypertension	Left frontal and parietal	Surgical resection	NR	Brain radiotherapy	Relapse in the left front cerebral lobe and right cerebellar hemisphere	Coexistence of left temporal meningioma
Schaefer et al[19]	2010	53/M	Headaches, cognitive impairment, visual loss and shortness of breath	Left occipital	Surgical resection	Neuron specific enlase and chromogranin A, negative for keratin, somatostatin, and S-100	Preoperative chemotherapy and postoperative radiotherapy	Relieved	Differing from the primary PCC only by loss at 18q on CGH analysis
Kharlip et al[20]	2010	23/F	Altered mental status	Left occipital, left parietal, and right frontal lobes	None	NR	Chemotherapy and radiotherapy	Relieved from neurologic symptoms but died 8 months later	NR
Schulte et al[21]	2012	73/M	Loss of cognitive function, a homonymous hemianopsia and left sided dysmetria	Right parietal lobe	Surgical resection	NR	Adjuvant whole brain radiotherapy	Relieved	First description of a cystic CNS metastasis
Miyahara et al[22]	2017	58/M	Headache, right hemiparesis, aphasia, and dysarthria	Left parietal lobe	Surgical resection	positive for chromagranin A, synaptophysin, and S100	Preoperative Stereotactic radiosurgery	No recurrence for 1 yr	NR
Boettcher  et al[23]	2018	24/M	Radiographic surveillance	Right posterior parietal, epidural lesion	Surgical resection	Chromogranin, synaptophysin	None	Died several weeks later	SDHB mutation
Cho et al[24]	2018	52/M	Headache, dizziness and motor aphasia	Multiple (more than 10) masses in the bilateral cerebral hemisphere and right pons	Surgical resection	Synaptophysin, S100	Radiotherapy	Died due to progressed intraabdominal cancer	First report in South Korea
Kammoun et al[25]	2019	29/F	Headache, vomiting, hypertension	Extradural lesion attached to the tentorium	Surgical resection	Chromogranin, synaptophysin, NSE	Postoperative whole brain radiotherapy	Death 1month after second surgery. No other metastases found	NR
Presenting case	2020	60/M	headache and enlarging scalp mass	Left temporal	Surgical resection	Vimentin, Syn and CgA, negative for S-100, EMA and CD10	None	No relapse of cranial mass	First report in China

CGH: Comparative genomic hybridization; CNS: Central nervous system; EMA: Epithelial membrane antigen; F: Female; M: Male; MEN: Multiple endocrine neoplasia; NR: No reported; PCC: Pheochromocytoma; SDHB: Succinate dehydrogenase subunit B.