• Jian Wang, Ding Yuan, Ya Lu, Yukui Ma, Bin Huang, Yi Yang, and Jichun Zhao.
• Department of Vascular Surgery, The West China Medical School of Sichuan University, West China Hospital of Sichuan University, Chengdu, Sichuan.
• Medicine (Baltimore). 2019 Jul 1; 98 (29): e16494.

RationaleIt is difficult to discriminate malignant pheochromocytoma (PCC) from benign PCC. The requirement of abdominal aortic and inferior vena cava reconstruction is extremely rare.Patient ConcernsWe here report a case of a large pheochromocytoma in a 56-year-old woman who complained of only hand trembling and had no hypertension or other symptoms. The operation was difficult because of a tight adhesion to the circumference of great vessels. A replacement of the aortocaval vessels with grafts was necessary to remove the tumor completely.DiagnosesUltrasonography, computed tomography (CT), and catecholamine assay revealed suspecting the retroperitoneal PCC.InterventionsTumor excision and reconstruction of the abdominal aorta and inferior vena cava by externally supported polytetrafluoroethylene (ePTFE) vessels were successfully performed.OutcomesA follow-up CT angiography showed no recurrence and graft vessels presented good patency after 7years. Catecholamine in urine and serum assay was normal.LessonsThe complete resection of the tumor and infiltrated great vessels were necessary for the long-term survival of patients with a large PCC. The ePTFE graft is a good substitute for vessel reconstruction.

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