Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2021; 9(12): 2791-2800
Published online Apr 26, 2021. doi: 10.12998/wjcc.v9.i12.2791
Malignant pheochromocytoma with cerebral and skull metastasis: A case report and literature review
Jun-Chen Chen, Dong-Zhou Zhuang, Cheng Luo, Wei-Qiang Chen
Jun-Chen Chen, Dong-Zhou Zhuang, Cheng Luo, Wei-Qiang Chen, Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Author contributions: Chen JC and Zhuang DZ contributed equally to this work and should be considered as co-first authors; Chen JC and Zhuang DZ participated in the patient treatment and wrote the manuscript; Chen JC and Luo C collected the clinical data and performed the literature review; Chen WQ helped to design and revise the paper; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Qiang Chen, MD, PhD, Professor, Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou 515041, Guangdong Province, China. wqchen2@163.com
Received: November 29, 2020
Peer-review started: November 29, 2020
First decision: December 21, 2020
Revised: December 31, 2020
Accepted: February 19, 2021
Article in press: February 19, 2021
Published online: April 26, 2021
Processing time: 136 Days and 15.6 Hours
Abstract
BACKGROUND

Malignant pheochromocytoma with cerebral and skull metastasis is a very rare disease. Combining our case with 16 previously reported cases identified from a PubMed search, an analysis of 17 cases of malignant cerebral pheochromocytoma was conducted. This literature review aimed to provide information on clinical manifestations, radiographic and histopathological features, and treatment strategies of this condition.

CASE SUMMARY

A 60-year-old man was admitted with a progressive headache and enlarging scalp mass lasting for 3 mo. Radiographic images revealed a left temporal biconvex-shaped epidural mass and multiple lytic lesions. The patient underwent a left temporal craniotomy for resection of the temporal tumor. Histopathological analysis led to identification of the mass as malignant pheochromocytoma. The patient’s symptoms were alleviated at the postoperative 3-mo clinical follow-up. However, metastatic pheochromocytoma lesions were found on the right 6th rib and the 6th to 9th thoracic vertebrae on a 1-year clinical follow-up computed tomography scan.

CONCLUSION

Magnetic resonance spectroscopy and histopathological examination are necessary to make an accurate differential diagnosis between malignant cerebral pheochromocytoma and meningioma. Surgery is regarded as the first choice of treatment.

Keywords: Malignant pheochromocytoma; Catecholamine-secreting; Cerebral metastasis; Skull metastasis; Meningioma; Magnetic resonance spectroscopy; Case report

Core Tip: Malignant pheochromocytoma with cerebral and skull metastasis is a very rare disease. We present the case of a 60-year-old male patient with malignant cerebral and skull pheochromocytoma who underwent surgical resection. A literature review was performed to provide information on clinical manifestations, radiographic and histopathological features, and treatment strategies of this condition. Clinical features may be similar between malignant cerebral pheochromocytoma and meningioma because they have a strong relationship in terms of genetic origin. Magnetic resonance imaging spectroscopy and histopathological examination are necessary to make an accurate differential diagnosis between malignant cerebral pheochromocytoma and meningioma. Different treatment strategies are discussed, including surgery, radiotherapy, and chemotherapy.