Hypertension secondary to bilateral pheochromocytoma: when a very long follow-up confirms that curing is healing

Background: Pheochromocytoma and paraganglioma are rare neuroendocrine tumors of the adrenal medulla characterized by the secretion of a large amount of catecholamines, especially noradrenaline. Their most common symptoms are headache, palpitations, and diaphoresis, while their cardiovascular complications include not only secondary hypertension and tachycardia but also more serious conditions like ischaemic heart disease, acute myocardial infarction, and cardiac arrhythmias, heart failure due to toxic cardiomyopathy, or pulmonary edema. The lack of guidelines for the management of these tumors makes them a challenge for clinicians. Long-term follow-up is missing from the current literature. Case presentation: In this article, we described the case of a patient affected by resistant hypertension related to bilateral pheochromocytoma and successfully treated with total adrenalectomy at a young age with resolution of hypertension in the long term (up to 15 years of follow-up). We also reviewed the advantages and disadvantages reported in the literature of either partial or total adrenalectomy, trying to find out which technique should be preferred to treat bilateral, non-metastatic pheochromocytoma and paraganglioma. Conclusions: Hypertension can be definitely cured after pheochromocytoma removal, even for the bilateral forms. To our knowledge, this is the longest case without the development of hypertension in the long term.