Open AccessHemorrhagic Necrosis of Pheochromocytoma Associated with Phentolamine Administration
Author(s) -
Charles W. Van Way,
Robert P. Faraci,
Henry C. Cleveland,
John Foster,
H. William Scott
Publication year - 1976
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197607000-00004
Subject(s) - phentolamine , medicine , pheochromocytoma , blockade , complication , necrosis , pathophysiology , surgery , anesthesia , propranolol , receptor
A case of ruptured pheochromocytoma is presented, the pathophysiology discussed, and the literature reviewed. Evidence is presented that the use of alpha-adrenergic blockade in general, and phentolamine in particular, may predispose to this complication. Twelve cases of massive hemorrhagic necrosis with or without rupture were found in the literature, including the present case. Six had no operation; one survived. Six had immediate operation; 4 survived. An additional case of hemorrhage into a small pheochromocytoma following phentolamine is presented. This tumor was neither ruptured nor massively necrotic, but the case supports the hypothesis that alpha-adrenergic blockade may cause hemorrhage within the pheochromocytoma.