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Diagnosis, localization, and management of pheochromocytoma pitfalls and follow‐up in 41 patients
Author(s) -
Samaan Naguib A.,
Mickey Robert C.,
Shutts Paul E.
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19881201)62:11<2451::aid-cncr2820621134>3.0.co;2-q
Subject(s) - medicine , pheochromocytoma , metanephrines , vanillylmandelic acid , scintigraphy , adrenalectomy , metanephrine , urinary system , radiology , blood pressure , surgery , homovanillic acid , receptor , serotonin
Forty‐one patients who had pheochromocytoma are described. These patients represent the experience of the authors over the last 19 years. The diagnoses, investigations, treatments, and pitfalls of this study and the management of these patients are described. The most sensitive screening test was the urinary measurement of catecholamines, vanillylmandelic acid (VMA), and metanephrines. The most useful localizing procedure was the metaiodobenzylguanidine (MIBG) scintigraphy and computed tomography (CT). After careful alpha and beta adrenergic blockade in 32 patients, no complications occurred during or after tumor resection. When this procedure was ignored even in patients who had normal blood pressure before surgery, severe cardiovascular complications occurred and two patients died. In familial pheochromocytoma, bilateral adrenalectomy with preservation of normal adrenal cortical tissue when possible may be the method of choice, but careful follow‐up is warranted.