Han, a 35-year-old patient, recently underwent robotic surgery for a recurrent adrenal tumor that caused her blood pressure to soar. This marks the second time Han has faced an adrenal tumor, with her first surgery occurring 15 years ago. Doctor Nguyen Hoang Duc, Head of Urology at the Urology - Nephrology - Andrology Center, Tam Anh General Hospital TP HCM, reported that the current tumor measured approximately 4 cm and was located in a critical area behind the vena cava, close to the renal artery and vein.

Adrenal tumors can lead to a dangerous increase in blood pressure by overproducing hormones such as: aldosterone, cortisol, or catecholamine. This hormonal imbalance causes the body to retain salt and water, constrict blood vessels, and increase heart rate, resulting in sudden hypertension. According to Doctor Duc, this was the underlying cause of Han's frequent headaches, rapid heartbeat, palpitations, and consistently elevated blood pressure, which often exceeded 140/90 mmHg and occasionally reached 200/110 mmHg. Without timely intervention, such tumors can lead to severe complications including heart failure, stroke, and irreversible kidney damage.

Doctors perform adrenal tumor removal surgery on Han with the assistance of the Da Vinci Xi robot. Photo: *Tam Anh General Hospital*.

Given the tumor's deep and perilous location, the surgical team utilized the Da Vinci Xi robot. This advanced robotic system allowed for precise maneuvers, ensuring complete tumor removal while preserving crucial blood vessels and minimizing the risk of complications. During the operation, a critical moment occurred when Han's blood pressure surged to 220/120 mmHg upon contact with the tumor. The surgical team, in close coordination with the anesthesiologists, promptly stabilized her condition, ensuring the procedure's safety.

Following the surgery, Han recovered quickly. She experienced minimal pain, resumed normal activities early, and was discharged after four days. She continues to have regular follow-up appointments for monitoring her health.

Doctor Nguyen Hoang Duc checks on Han's health after surgery. Photo: *Tam Anh General Hospital*.

Adrenal tumors are a common cause of secondary hypertension. They can manifest as sudden, severe hypertensive crises accompanied by a rapid heart rate, sweating, and headaches, or as prolonged, difficult-to-control high blood pressure. While difficult to prevent due to their association with endocrine disorders and genetic factors, potential complications can be mitigated through regular health screenings and monitoring.

Doctor Duc advises individuals with early-onset, fluctuating, or difficult-to-manage high blood pressure, a family history of hypertension, or existing endocrine conditions to seek specialist consultation and hormone testing for early detection. Maintaining a healthy lifestyle is also essential for stabilizing blood pressure and protecting cardiovascular health.

Ha Thanh - Bao Anh

*Patient's name has been changed.