Robot-assisted laparoscopic resection of giant cystic pheochromocytoma: A case report.

RATIONALE: The giant cystic pheochromocytomas (>10 cm) are exceedingly rare. Due to the massive size of tumor, traditional laparoscopic minimally invasive surgery poses significant technical challenges. PATIENT CONCERNS: We present the case of a 53-year-old male patient who was admitted due to poorly controlled hypertension and an ultrasound-detected right adrenal mass. DIAGNOSES: Abdomen computed tomography scans revealed a cystic mass (11 cm × 9 cm) in the right adrenal gland, highly suggestive of pheochromocytoma. The laboratory findings demonstrate significantly elevated levels of catecholamines and their metabolites. Histopathological examination confirmed the diagnosis of cystic pheochromocytoma. INTERVENTIONS: After 2 weeks of preoperative α-blockade preparation, the patient successfully underwent robot-assisted laparoscopic resection of the right adrenal tumor. OUTCOMES: At the 6-week postoperative evaluation, catecholamine levels had normalized. Blood pressure has returned to normal range in the absence of antihypertensive therapy and there are no more symptoms of dizziness and palpitations. The patient remained disease-free with no evidence of recurrence or metastasis during 1 year of surveillance. LESSONS: In this case, we demonstrate the successful resection of a giant cystic pheochromocytoma in the right adrenal gland using robotic-assisted laparoscopy. This approach overcomes the technical limitations of conventional laparoscopy for large-volume adrenal pheochromocytomas and provides a novel therapeutic alternative for these challenging tumors.