Bilateral pheochromocytoma, renal cell carcinoma and thyroid carcinoma in a patient under hemodialysis: A case report

A 66-year-old woman had been on hemodialysis for 20 years. She ofen suffered from chest discomfort and paroxysmal hypertension. Computed tomography revealed a bilateral adrenal tumor and serum cathecholamine levels were significantly elevated. An 123I-meta-iodo-benzyl guanidine (MIBG) scintigram showed increased radionuclide uptake in the bilateral adrenal glands. She was referred to us for surgical treatment of bilateral pheochromocytoma. Moreover, she had a left renal tumor, thyroid tumor and bilateral ovarian tumor. Right partial adrenalectomy, left adrenalectomy and left radical nephrectomy were performed for bilateral pheochromocytoma and the left renal tumor with a retroperitoneoscopic approach. Pathological examination demonstrated bilateral pheochromocytoma and left renal cell carcinoma. Left thyroidectomy was performed for the thyroid tumor and the pathological diagnosis was papillary carcinoma. Bilateral adnexectomy was performed for the bilateral ovarian tumor and the pathological diagnosis was cystic adenoma. Pheochromocytoma is rarely seen in a patient under hemodialysis and malignancies have been established as an important complication of long-term dialysis.