Abstract
A 59-year-old female patient visited the Department of Orthopedic Surgery for numbness of the extremities and difficulty in walking. Computed tomography evaluation revealed elevated blood glucose and hypokalemia, and a left adrenal tumor. Accumulation of the radionuclide in the tumor was seen in 123-MIBG scintigraphy, and T1- and T2-weighted magnetic resonance imaging（MRI）showed high intensity. Lacking abnormal findings in brain MRI, we finally diagnosed her condition as ACTH-producing pheochromocytoma and treated her with laparoscopic left adrenalectomy. Steroid replacement therapy was performed. Pulmonary edema and cytomegalovirus pneumonia occurred postoperatively. The pneumonia was treated with ganciclovir. Two months after the operation the patient recovered and 10 months later steroid replacement therapy was terminated. ACTH-producing pheochromocytoma presents various symptoms due to a high cortisol level and the condition of the patient is usually unstable preoperatively. Despite this, it is reasonable and safe to perform adrenalectomy with laparoscopic surgery.
