Bariatric Surgery for Pre-Operative Weight Reduction in a Patient with Pheochromocytoma

ABSTRACT Objective: Obesity is a predictor of adverse outcomes in patients undergoing adrenalectomy. Pre-adrenalectomy weight reduction is becoming an increasingly common challenge in view of the rising prevalence of obesity. This case report describes the clinical course of a morbidly obese gentleman who underwent bariatric surgery prior to pheochromocytoma resection. Methods: A morbidly obese man with a body mass index of 43 kg/m2 had an incidental finding of an 8.5 cm right-sided pheochromocytoma. Dietary and pharmacologic methods of weight loss lead to a 6 kg weight loss over a 12-month period. Multidisciplinary discussion concluded that weight loss and tumor resection were priority and the patient proceeded to laparoscopic sleeve gastrectomy with appropriate peri-operative alpha- and beta-blockade. Results: Laparoscopic sleeve gastrectomy proceeded without complication and lead to a further 23 kg of weight loss and the pheochromocytoma was resected 2 months later. Conclusion: Bariatric surgery for pre-operative weight loss in medically prepared patients with pheochromocytoma should be considered for morbidly obese patients in whom nonsurgical weight loss is unsuccessful. Abbreviations: BMI = body mass index