Transarterial embolisation of spontaneous adrenal pheochromocytoma ruptures using polyvinyl alcohol particles

Pua U, Wong DES
Correspondence: Dr Pua Uei, druei@yahoo.com

ABSTRACT
The spontaneous rupture of a phaeochromocytoma is a rare and potentially fatal complication. Prompt diagnosis, patient stabilisation and adrenectomy are crucial for survival. However, it is known that adrenectomy performed in the emergency setting is associated with a high mortality rate, in contrast to the negligible mortality rate with elective surgery. We describe transcatheter arterial embolisation (TAE) using polyvinyl alcohol particles (PVA) in restoring haemodynamic stability during an acute phaeochromocytoma rupture in a 67-year-old man to avoid the risks of performing an emergency adrenectomy. TAE improves the prognosis significantly by prolonging treatment time for patient optimisation and to enable the possibility of elective adrenectomy. To the best of our knowledge, TAE using PVA in an acute phaeochromocytoma rupture has not been previously reported in the English literature.

Keywords: adrenal haemorrhage, embolisation, phaeochromocytoma, polyvinyl alcohol particles, transcathetic arterial embolisation
Singapore Med J 2008; 49(5): e126-e130