Peritoneal implantation of pheochromocytoma 8 years after adrenalectomy: A rare cause of delayed recurrence

Peritoneal implantation of pheochromocytoma following adrenalectomy is an exceptionally rare mechanism of recurrence, typically related to intraoperative tumor spillage or capsular rupture. It may present after a prolonged latency and mimic metastatic disease. We report the case of a 43-year-old man who presented with occasional palpitations, headache, and hypertension 8 years after right adrenalectomy for pheochromocytoma. Imaging revealed multiple peritoneal soft-tissue lesions. I-123 MIBG scintigraphy demonstrated avid uptake in these lesions, confirming peritoneal implantation of pheochromocytoma. This case highlights the importance of considering peritoneal implantation even years after surgery and the value of functional imaging in diagnosis and follow-up.