POMC and pheochromocytoma: The contraindications for LA, reported in recent literature are adrenocortical carcinomas that invade surrounding structures, large tumors greater than 10 to 12 cm in diameter, and malignant ACTH-secreting pheochromocytoma with lymphadenopathy.[11] Other limitations to LA are patients unfit for laparoscopy due to coagulation disorder or co-morbid conditions.