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PHEOCHROMOCYTOMA – AN ANALYSIS OF 123 PATIENTS
Author(s) -
Selvan C. K.,
Nair A.,
Paul M. J.,
Abraham D. T.,
Thomas N.,
Seshadri M. S.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04118_13.x
Subject(s) - medicine , pheochromocytoma , palpitations , asymptomatic , diabetes mellitus , secondary hypertension , presentation (obstetrics) , urinary system , surgery , blood pressure , endocrinology
Background Pheochromocytomas are diagnosed in <1% of patient evaluated for hypertension. Methodology A retrospective analysis of case records of those patients with histopathologically confirmed pheochromocytoma in our hospital from 1976–2006 [30 YEARS] was conducted. Result A total of 123 patients were diagnosed during this period. The median age at presentation was 31 years (range 9–71) with a male to female sex distribution of 75% and 36%. 80% were hypertensive at the time of diagnosis. Headache(84%), palpitations(64%) and sweating(60%) are the most common presenting complaints.Tachycardia [>100 per minute]were seen in 31%. Hypertensive changes in eyes were seen in 87%. In ECG, QTc prolongation in 26%, left ventricular hypertrophy in 30%. Diabetes mellitus/IGT was seen in 35%. Elevated urinary VMA (24 hrs) was seen in 93% when done on 3 consecutive days. MIBG was positive in 85%. Malignant pheochromocytoma was diagnosed by tumour invasion/metastasis seen 10.44%. Extra adrenal pheochromocytoma 18%, followed by bilateral pheochromocytoma in 11%. Hereditary pheochromocytoma in 13% which include 5 with Von Hippel Lindau and 6 with MEN. A median follow‐up was 12 months (range 1–204) in which persistent hypertension was seen in 16%. Cholelithiasis in 7%. Conclusion In our case series the mean age (31 yrs) of presentation seems to be younger compared to other case series. 16% of our patients were asymptomatic at the time of presentation. Urinary VMA was elevated in 93% of patients when done in 3 consecutive samples. Extra adrenal pheo was common in our patients (18%). MIBG was false negative in 15% of those patients with pheochromocytoma.