Pheochromocytomas are catecholamine-secreting tumors that arise from chromaffin cells and most of them cause curable secondary hypertension. To prevent the intraoperative and postoperative complications, precise pre-operative diagnosis,
localization and
adequate preoperative managements are necessary, but sometimes those are not so easy because of the variable symptoms and signs, So, to be some help for the diagnosis and management of pheochromocytomas, we analyzed the cases with
pheochromocytomas
that
were operated in our clinic from August, 1983 to July 1993 and obtained the following results.
Male to female ratio was 1:1 and there was 1:1 and there was no difference in distribution by age. Hypertension, which was present in 21 cases(87.5%) was the most common symptom and paroxysmal in nature in 13 cases(61.9%). accompanying diseases
were 4
cases o new type of multiple endocrine neoplasia in 2 pedigrees which involve pheochromocytomas and pancreatic islet tumors; 2 case of renovascular hypertension; and 2 cases of cholelithiasis.
Plasma epinephrine was elevated in 60%(12/20), plasma norepinephrine was elevated in 90%(18/20) and 24-hour urine VMA was elevated in 95.8%(23/24). Elevated labaratory values returned to normal in most cases within one week postoperatively. There
were
no 'differences in the level of preoperative plasma catecholamines and 24-hour urine VMA between benign and malignant pheochromocytomas.
Preoprative localization was made in all cases and CT was the most excellent localization method. There were 19 cases of adrenal locations, 17 cases of which were unilateral and 2 cases were bilateral; 4 cases of extraadrenal locations, which was
proved
to be malignant. There were 6 cases of malignancy proved by histologic evidence of invading adjacent tissues or organs. Operation were excisions for extraadrenal lesions, including palliative excision in one case, and unilateral subototal or
total
adrenalectomy for unilateral lesions and bilateral subtotal adrenalectomy for bilateral lesions. There were no difference in recurrences between unilateral subtotal and total adrenalectomies.
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