PMC6403170_01
The CT images of the tumor where venous involvement was considered. Fig. 1D: inferior vena cava(arrow 1), portal vein (arrow 2); Fig. 1E: right renal vein(arrow 1), left renal vein(arrow2); Fig. 1F:right renal vein(arrow 1), left renal vein(arrow2), inferior vena cava(arrow 3).
gr1.jpg
PMC6403170_01_gr1.jpg
fig0005
A significantly elevated level of urinary catecholamine and a typical adrenal mass on abdominal CT scan (Fig. 1) led to the diagnosis of a large right pheochromocytoma (16 cm x 15 cm x 10 cm). The right renal vein and the inferior vena cava (IVC) were involved by the tumor on CT scanning (Fig. 1).
The macroscopic and microscopic images of the tumor. Fig. 3A: right renal vein(1), inferior vena cava(2), left renal vein(3), portal vein(4).
gr2.jpg
PMC6403170_01_gr2.jpg
fig0010
The tumor was adherent but had not involved the wall of the IVC (Fig. 2).Fluctuations in the BP and heart rate occurred when the tumor was mobilized, with hypertensive peaks reaching to 255/158 mmHg and a heart rate up to 150bpm (Fig. 3).
This figure represents the vital signs during surgery: systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (bpm).
gr3.jpg
PMC6403170_01_gr3.jpg
fig0015
The tumor was adherent but had not involved the wall of the IVC (Fig. 2).Fluctuations in the BP and heart rate occurred when the tumor was mobilized, with hypertensive peaks reaching to 255/158 mmHg and a heart rate up to 150bpm (Fig. 3). Phentolamine and sodium nitroprusside were used to stabilize the BP at the 70~160/40~100mmHg and HR at 60~120bpmranges (Fig. 3).