Adrenalectomy for Sporadic Isolated Adrenal Pheochromocytoma: Case Report and Discussion

Background: Adrenalectomy is the treatment for Pheochromocytoma, a rare neuroendocrine tumor. Many surgical techniques and approaches exist, and the choice mostly relies on clinical indications, logistic resources, and surgeon’s experience. This case report highlights the challenges of diagnosing and managing pheochromocytoma in resource-limited settings and it equally advocates for open adrenalectomy as a viable option in such contexts. Case Presentation: A 56 years old woman presented on routine consultation, for a reluctant paroxysmal hypertension, associated with a painless right flank mass. History was remarkable for type 2 diabetes mellitus, followed-up for over 6 years and abdominal surgery 20 years earlier. On clinical assessment, the patient presented with the classic symptoms of Menard’s Triad and elevated serum metanephrine and normetanephrine. Imaging revealed a large homogenous right adrenal mass. Preoperative medical care consisted in initiation of catecholamine blockade. Due to resource limitations, the patient underwent an open transperitoneal adrenalectomy, resulting in resolution of symptoms and normalization of biochemical markers. Conclusion: Adrenalectomy is the treatment for Pheochromocytoma; Transperitoneal laparotomy remains an option in resource-limited settings with substantial positive outcomes.