Spontaneous rupture of adrenal pheochromocytoma

Summary Spontaneous rupture of pheochromocytoma is an extremely rare, but deadly condition with a mortality rate of approximately 32%. We report a case of spontaneous rupture of adrenal pheochromocytoma, which resulted in a retroperitoneal hematoma and respiratory distress. The 69-year-old female visited our emergency department because of progressive abdominal pain for 3 days and fever and shortness of breath for 1 day. Abdominal computerized tomography was performed and an 8 cm mass, with a hematoma in the retroperitoneal space, was revealed. Retroperitoneal exploration was performed on account of progressive respiratory distress and suspected superimposed infection. Elevated blood pressure was noted during anesthesia induction. During the operation, the tumor was found to have originated from the left adrenal gland. A drop in blood pressure was noted after removal of the tumor. Normal blood pressure was restored after fluid challenge and administration of vasopressive agents. The histopathological study of the tumor demonstrated adrenal pheochromocytoma. The patient was in good health, without any sequel at a 6-month postoperative follow up, and eventually fully recovered.