24/04/2025
LAPAROSCOPIC BILATERAL ADRENALECTOMY done at Benazir Bhutto Hospital Rawalpindi: Case Presentation
24 year-old male presented with episodic headaches, palpitations, profuse sweating, and sustained hypertension. Clinical examination revealed a hypertensive crisis, necessitating further workup. Biochemical evaluation demonstrated significantly elevated plasma metanephrines and 24-hour urinary catecholamines, supporting the diagnosis of pheochromocytoma. Contrast-enhanced CT scan of the abdomen identified bilateral adrenal masses with imaging characteristics suggestive of pheochromocytoma.
Surgical Management
Considering the bilateral nature of the disease and the potential for malignant transformation, laparoscopic bilateral adrenalectomy was performed. Meticulous preoperative management was ensured, including adequate alpha- and beta-blockade to prevent intraoperative hypertensive crises. The surgery was completed successfully with minimal blood loss, and no intraoperative complications were encountered.
Postoperative Course
The patient had an uneventful recovery and was started on steroid replacement therapy to compensate for adrenal insufficiency. Histopathological examination confirmed the diagnosis of bilateral pheochromocytoma. Genetic evaluation is currently underway.
