Diagnostic and therapeutic challenges in the management of silent and functional giant pheochromocytoma

Giant pheochromocytoma is a rare retroperitoneal tumor that is "clinically and biochemically quiet" most of the time, posing diagnostic and treatment hurdles in ordinary surgical practice. This case study includes four participants. The average age of the patients was 56.5 years. Two patients exhibited symptoms and biochemical diagnostic characteristics, but the other two were clinically and biochemically silent. Preoperative imaging revealed the diagnosis in two individuals. In two patients with an initial diagnosis, all patients underwent laparotomy after preoperative preparation and stabilization. The diagnosis of giant pheochromocytoma was confirmed histo-pathologically in all four individuals with a PASS score of less than 3. All patients were disease-free and were being followed on a routine basis. Even though it is uncommon, "clinically and biochemically silent" Giant pheochromocytoma should be considered as a differential diagnosis of retroperitoneal tumor, where preoperative diagnosis by imaging and biopsy, alongside patient preparation and stabilization, reduces adverse intraoperative and postoperative events.