a Novel Approach for Treatment of Metastatic Pheochromocytoma

Few patients withmetastatic pheochromocytoma are suitable candidates for surgical resection of the tumor.This correspondence introduces radiofrequency ablation (RFA) as an alternate treatmentmodality in pheochromocytoma. RFA is a safe, predictable, and effective method for localtumor destruction in primary and metastatic carcinomas (2-7). We report on a patient withmetastatic pheochromocytoma with a rapidly growing bone metastasis who was treated withRFA.The patient, a 42-year-old man, first presented with episodes of hematuria, hypertension, andpalpitations. A 24-hour urine collection demonstrated elevated levels of catecholamines andmetanephrines. Computed tomography (CT) scan revealed a 5.5 × 7.5 × 8.0-cmpheochromocytoma invading the posterior urinary bladder wall. His tumor was consideredunresectable. The patient was treated with radiotherapy and six cycles of chemotherapy, with80% tumor shrinkage followed by cystectomy. CT scans 5 years later showed lung metastasesand a 0.5-cm third lesion on the right rib. The lesion grew gradually, then rapidly to 3 cm in