本文报道1例转移性复发性肾上腺嗜铬细胞瘤。患者为青年男性，因反复胸闷、胸痛就诊，2019年首次发现右侧肾上腺占位并行腹腔镜下右侧肾上腺肿物切除术，术后病理证实为嗜铬细胞瘤，Ki-67约1%～2%（+），SDH-B（+）。2022年患者出现术区复发并腹膜、大网膜、淋巴结转移，接受减瘤手术及环磷酰胺、长春新碱和达卡巴嗪联合方案化疗。2025年患者再次出现术区复发及腹膜多发转移，行二次减瘤手术并取组织行患者来源类器官培养，药敏结果显示舒尼替尼可显著抑制类器官三磷酸腺苷活性及肾上腺素分泌，经广东省医学会泌尿外科疑难病例多学科会诊（MDT）讨论后给予舒尼替尼37.5 mg/d口服靶向治疗。随访至今，患者一般状况良好，无胸闷、心悸等不适。本例提示，转移复发性嗜铬细胞瘤的临床管理不能局限于传统病理低危表象，需结合复发模式、转移证据及全病程演变综合评估其恶性潜能。此次MDT整合了泌尿外科、影像科、病理科及肿瘤内科等多学科分析，明确手术减瘤、系统治疗选择及长期随访策略的个体化治疗方案，体现出MDT在复杂病例的诊疗中具有重要临床指导价值。

This article reports a case of metastatic recurrent adrenal pheochromocytoma in a young man presenting with recurrent chest tightness and chest pain. In 2019, a right adrenal mass was detected, and laparoscopic resection of the right adrenal tumor was performed. Pathology confirmed pheochromocytoma, with a Ki-67 index of 1%-2% and positive SDH-B expression. In 2022, recurrence at the operative site with peritoneal, greater omental, and lymph node metastases was identified, and the patient underwent debulking surgery followed by cyclophosphamide, vincristine, and dacarbazine (CVD) chemotherapy. In 2025, recurrent disease at the operative site and multiple peritoneal metastases were detected again. A second debulking surgery was performed, and tumor tissue was obtained for patient-derived organoid culture. Drug sensitivity testing showed that sunitinib markedly inhibited adenosine triphosphate (ATP) activity and epinephrine secretion in the organoids. After multidisciplinary consultation on difficult cases in Guangdong Urological Association, oral targeted therapy with sunitinib at 37.5 mg/day was initiated. At the latest follow-up, the patient remained in good general condition, without chest tightness, palpitations, or other discomfort. This case suggests that the management of metastatic recurrent pheochromocytoma should not rely solely on conventionally low-risk pathological features, but should incorporate recurrence pattern, metastatic evidence, and the longitudinal disease course to assess malignant potential. In this case, MDT discussion integrated input from Urology, Radiology, Pathology, Medical Oncology, and other specialties. This collaborative approach helped establish an individualized strategy involving surgical debulking, systemic treatment selection, and long-term follow-up, thereby highlighting the important clinical value of MDT-based decision-making in complex cases.