Pheochromocytomas of the spine are uncommon and require careful preoperative planning. The authors retrospectively reviewed the charts of 5 patients with metastatic spinal
pheochromocytoma who had undergone surgical treatment over the past 10 years at their medical center. They reviewed patient age, history of
pheochromocytoma resection, extent and location of
metastases, history of alpha blockage, surgical level,
surgical procedure, postoperative complications,
tumor recurrence, and survival.
Metastases involved the cervical (1 patient), thoracic (3 patients), and lumbar (2 patients) levels. Preoperative treatment included primary
pheochromocytoma resection,
chemotherapy, alpha blockade, embolization, and radiation. Three patients had
tumor recurrence, and 2 underwent 2-stage reoperations for
tumor extension. Hemodynamic complications were common: 2 patients developed pulseless electrical activity arrest within 4 months after surgery, 1 patient had profound postoperative
tachycardia with
fever and an elevated
creatine kinase level, and 1 patient experienced transient postoperative
hypotension and
paraplegia. One patient died of complications related to disseminated cerebral and
spinal disease. With careful preoperative and surgical management, patients with symptomatic metastatic spinal
pheochromocytoma can benefit from aggressive surgical treatment. Postoperative cardiovascular complications are common even months after surgery, and patients should be closely monitored long term.