PRIMARY HEPATIC PHEOCHROMOCYTOMA

Pheochromocytomas are uncommon tumors that represent a potentially cur able cause of hypertension. They are usually located in the adrenal gl ands, but 10% arise from extra-adrenal sites, located along the parave rtebral sympathetic chains. We report a case of primary hepatic pheoch romocytoma responsible for a severe hypertension in a 24-year-old man. Echotomography showed a lightly heterogeneous mass located in the seg ment 8 of the liver. Iodine 131 - metaiodobenzylguanidine scintigraphy showed a large hepatic concentration of the tracer and no other local ization. This tumor appeared highly vascularized on enhanced CT scan a nd on aortic angiography. Magnetic resonance imaging revealed a hepati c tumor with a high signal intensity on T2-weighted images and with a signal isointense to the liver on T1-weighted images. The hepatic veno us sampling contained the highest catecholamine level, whereas the adr enal venous sampling was normal. After surgical resection of the hepat ic tumor, the tension level and catecholamines plasmatic level normali zed. no recurrent symptoms appeared during a 3-year follow-up.