Circumstances of discovery of phaeochromocytoma: a retrospective study of 41 consecutive patients.

OBJECTIVE Phaeochromocytoma is a rare tumour of the chromaffin cells, the diagnosis of which is based on an assay of metanephrines and treatment is surgical excision of the tumour. It is usually discovered due to a rich and varied symptomatology or classic paroxysmal hypertension. The main purpose of this study was to specify the exact circumstances of discovery of the phaeochromocytomas operated on in our university hospital between 1990 and 2002. DESIGN AND METHODS Forty-one consecutive and complete case reports of patients who had surgery for phaeochromocytoma were analysed retrospectively. This series includes 10 patients with a genetic disorder predisposing to phaeochromocytoma. RESULTS The association of headaches and palpitations with sweating was found in only 24% of cases (10/41). Blood pressure anomalies led to the discovery of phaeochromocytoma in only 51% of cases (21/41) and 59% (24/41) of all the patients suffered from hypertension. In almost half the cases (20/41), the tumour was discovered by an imaging method (ultrasonography, CT scan or MRI) which had been performed for reasons unrelated to a blood pressure abnormality. CONCLUSIONS Phaeochromocytoma, the symptoms of which are not very specific and during which hypertension is present in only half the patients, is a disease that remains rare. Its incidence could be increasing because of changes in the method of detection. Indeed, in our study, different imaging techniques led to its incidental discovery in half of the cases.

[1]  K. Nathanson,et al.  Pheochromocytoma: the expanding genetic differential diagnosis. , 2003, Journal of the National Cancer Institute.

[2]  C. Eng,et al.  The pressure rises: update on the genetics of phaeochromocytoma. , 2002, Human molecular genetics.

[3]  S. Ito,et al.  Changes in clinical features and long-term prognosis in patients with pheochromocytoma. , 2000, American journal of hypertension.

[4]  N. Abumrad,et al.  Clinical experience over 48 years with pheochromocytoma. , 1999, Annals of surgery.

[5]  W. Young,et al.  Adrenal incidentaloma: An important component of the clinical presentation spectrum of benign sporadic adrenal pheochromocytoma , 1999 .

[6]  I. Francis,et al.  Imaging of adrenal masses. , 1997, The Urologic clinics of North America.

[7]  D. Streeten,et al.  Mechanisms of orthostatic hypotension and tachycardia in patients with pheochromocytoma. , 1996, American journal of hypertension.

[8]  J. Carney,et al.  Clinical Spectrum and Outcome of Functional Extraadrenal Paraganglioma , 1996, World Journal of Surgery.

[9]  G. Smythe,et al.  Laboratory Diagnosis of Phaeochromocytoma: Which Analytes Should We Measure? , 1993, Annals of clinical biochemistry.

[10]  J. Cottet-Emard,et al.  Measurement of plasma methoxyamines for the diagnosis of pheochromocytoma. , 1991, Hormone research.

[11]  D. Goldstein,et al.  Reversibility of catecholamine-induced dilated cardiomyopathy in a child with a pheochromocytoma. , 1987, The New England journal of medicine.

[12]  B. Wocial,et al.  Clinical and Biochemical Aspects of Pheochromocytoma , 1985 .

[13]  B. Wocial,et al.  Clinical and biochemical aspects of pheochromocytoma. Report of 110 cases. , 1985, Cardiology.

[14]  A. Krstulović,et al.  Investigations of catecholamine metabolism using high-performance liquid chromatography: analytical methodology and clinical applications. , 1982, Journal of chromatography.

[15]  J. Ménard,et al.  [Screening for phaeochromocytoma : in which hypertensive patients? A semiological study of 2585 patients, including 11 with phaeochromocytoma (author's transl)]. , 1981, La Nouvelle presse medicale.

[16]  E. Rooke,et al.  The neurologist's experience with pheochromocytoma. A review of 100 cases. , 1966, JAMA.

[17]  R. Smithwick,et al.  Pheochromocytoma; a discussion of symptoms, signs and procedures of diagnostic value. , 1950, The New England journal of medicine.