Single-Port Robotic Bilateral Cortical-Sparing Adrenalectomy in MEN 2A Patients With Bilateral Pheochromocytomas: A Case Report

Multiple endocrine neoplasia type 2A (MEN 2A) is a hereditary disorder characterized by medullary thyroid carcinoma (MTC), pheochromocytomas, and primary hyperparathyroidism. We present the case of a 28-year-old male diagnosed with MEN 2A, exhibiting bilateral MTC and bilateral pheochromocytomas. The patient underwent a total thyroidectomy with bilateral central lymph node dissection, followed by bilateral cortical-sparing adrenalectomy (CSA) utilizing single-port (SP) robotic posterior retroperitoneoscopic approach. The patient’s blood pressure remained consistently stable at an average of 125/85 mmHg after surgery, and he was discharged without complications on postoperative day 5 with good postoperative recovery and patient satisfaction. Adrenal function was successfully preserved, allowing for gradual tapering of hormone replacement therapy. This case underscores the efficacy of SP robotic CSA in managing bilateral pheochromocytomas within the context of MEN 2A, highlighting its role in tumor resection while maintaining adrenal function. The minimally invasive nature of the SP robotic approach and CSA offered advantages including reduced operative time, diminished postoperative discomfort, and enhanced cosmetic outcomes. Nonetheless, careful patient selection and diligent long-term follow-up are imperative to monitor adrenal function and detect potential tumor recurrence.