Synchronous transperitoneal robotic-assisted bilateral cortical-sparing adrenalectomy for pheochromocytomas in a patient with multiple endocrine neoplasia type 2a (MEN2A) syndrome: a case report

Background: Pheochromocytoma is a rare neuroendocrine tumor, and bilateral pheochromocytomas is even less common. Due to the limited experience with such cases, this study aims to explore the optimal surgical strategy, assess the potential advantages of robotic surgery, and evaluate surgical outcomes for managing bilateral pheochromocytomas.

Case description: This report presented a case of a 33-year-old woman with bilateral pheochromocytomas related to multiple endocrine neoplasia type 2a (MEN2A), who was successfully managed by synchronous transperitoneal robotic-assisted bilateral cortical-sparing adrenalectomy. This strategy reduced blood loss, improved cosmetic outcomes, preserved adrenal function, and gradually reduced the need for hormone replacement, ultimately leading to discontinuation of hydrocortisone therapy. The surgery was performed without significant complications. The patient recovered well and had normal blood pressure and hormone level at the 1-year postoperative follow-up.

Conclusions: Synchronous transperitoneal robotic-assisted bilateral cortical-sparing adrenalectomy is a safe, effective, and efficient approach for bilateral pheochromocytomas, and is favorable for rapid recovery and cosmetic demand. This treatment is more advantageous when dealing with multiple neuroendocrine tumors.