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Purpose <p>We aimed to retrospectively assess the safety and outcomes of percutaneous radiofrequency ablation (RFA) of pheochromocytomas in patients with von Hippel–Lindau disease (VHLD).</p> Materials and methods <p>Between September 2012 and February 2025, eight pheochromocytomas (median, 15.7&#xa0;mm; range, 5.5–22.5&#xa0;mm) in six patients with VHLD (sex ratio = 3:3; median, 30.5 years; range, 19–48 years) were treated in eight computed tomography (CT)-guided RFA sessions. Four patients with six pheochromocytomas had undergone total or partial adrenalectomy, whereas two with two pheochromocytomas had not. No patients had pre-existing hypertension, palpitations, or sweating. Premedication was administered before the two sessions. Treatment outcomes, hypertensive crises, and other complications were assessed. Follow-up period ranged from 1 to 134 (median, 60.5) months. Wilcoxon matched-pairs signed-rank test was used for statistical analysis.</p> Results <p>Of the eight pheochromocytomas, seven were completely ablated in one session, and no local tumor progression or recurrence was observed during follow-up. Only one patient had a residual tumor when a low tube current (30 mAs) was used. Of the eight RFA sessions, five resulted in elevated blood pressure during the RFA cycles (<i>p</i> = 0.0078). Hypertensive crises were managed well with intravenous antihypertensive medication without complications. No patient experienced adrenal insufficiency or other major complications. A small amount of bleeding was detected around the pheochromocytomas in all sessions but did not require transfusion or intervention.</p> Conclusion <p>CT-guided RFA can safely treat pheochromocytomas in patients with VHLD. Hypertensive crises are frequent but well controlled. It may achieve good oncological outcomes and preserve adrenal function.</p>

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Computed tomography-guided radiofrequency ablation of pheochromocytomas in a small case series with von Hippel–Lindau disease: treatment safety and outcomes

  • 期刊论文

  • 发表日期：

    2025年10月24日

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  • Byung Kwan Park

摘要

Purpose

We aimed to retrospectively assess the safety and outcomes of percutaneous radiofrequency ablation (RFA) of pheochromocytomas in patients with von Hippel–Lindau disease (VHLD).

Materials and methods

Between September 2012 and February 2025, eight pheochromocytomas (median, 15.7 mm; range, 5.5–22.5 mm) in six patients with VHLD (sex ratio = 3:3; median, 30.5 years; range, 19–48 years) were treated in eight computed tomography (CT)-guided RFA sessions. Four patients with six pheochromocytomas had undergone total or partial adrenalectomy, whereas two with two pheochromocytomas had not. No patients had pre-existing hypertension, palpitations, or sweating. Premedication was administered before the two sessions. Treatment outcomes, hypertensive crises, and other complications were assessed. Follow-up period ranged from 1 to 134 (median, 60.5) months. Wilcoxon matched-pairs signed-rank test was used for statistical analysis.

Results

Of the eight pheochromocytomas, seven were completely ablated in one session, and no local tumor progression or recurrence was observed during follow-up. Only one patient had a residual tumor when a low tube current (30 mAs) was used. Of the eight RFA sessions, five resulted in elevated blood pressure during the RFA cycles (p = 0.0078). Hypertensive crises were managed well with intravenous antihypertensive medication without complications. No patient experienced adrenal insufficiency or other major complications. A small amount of bleeding was detected around the pheochromocytomas in all sessions but did not require transfusion or intervention.

Conclusion

CT-guided RFA can safely treat pheochromocytomas in patients with VHLD. Hypertensive crises are frequent but well controlled. It may achieve good oncological outcomes and preserve adrenal function.