• A M Lucon, R Falci, J N Praxedes, M C Machado, L B Saldanha, M M Machado, and S Arap.
• Division of Urology, Department of Surgery, Faculty of Medicine, University of São Paulo, Brazil. webmaster@urologia.hcnet.usp.br
• Sao Paulo Med J. 2001 Mar 1; 119 (2): 868886-8.

ContextExtension of pheochromocytomas to the inferior vena cava is rare. Multicentric tumors are rare as well, being present in up to 10% of cases. Surgery is the treatment of choice because of the long-term survival free of disease.DesignCase report.Case ReportWe report on a case of right adrenal pheochromocytoma with extension to the supra-diaphragmatic vena cava, which underwent surgical excision through thoracophrenic laparotomy without the need for cardiopulmonary bypass. In a 6-year follow-up, another pheochromocytoma was found in the infra-renal Zuckerkandl's organ. Complete surgical excision of the tumor was performed by a median laparotomy and complete retroperitoneal dissection. In both cases, the total removal of the pheochromocytoma has been guaranteed by having margins free of tumor and a normal post-operative level of catecholamines. The pathological study revealed a malignant pheochromocytoma with margins free of neoplasia in both specimens.

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