Endocrine Abstracts

Objective: To retrospectively evaluate the results of the pheochromocytoma surgery in our institution assessing the surgical complications, perioperative hemodynamic instability and oncologic outcomes.

Methods: The medical records of patients admitted for pathologically confirmed pheochromocytoma between 2000 and 2015 were reviewed. Patients with paragangliomas were excluded.

Results: We identified 40 patients with 43 resected pheochromocytomas. The mean age was 47 years with an equal distribution between genders. Twelve cases (30%) had a syndrome known to have an increased incidence of pheochromocytoma. The mean tumor size was 7 cm (range of 1.5–17.2 cm). Most of the lesions were functional (95%) and preoperative alpha-blockade has been instituted in 93% of the patients, with 48% having a beta blocker simultaneously. Fourteen cases (30%) underwent a minimal invasive approach. The mean operative time was 150 min and the median of intraoperative blood loss was 150 ml. More than a half of the patients (54%) had a hypertensive crisis at some point during surgery, almost always associated with manipulation of the lesion. Ten patients (25%) required vasopressor support after adrenal gland removal. Two patients (4.6%) had CTCAE 3/4 complications. There were no cases of mortality and the median length of stay was seven days. Two (5%) cases were defined as malignant: one secondary to metastatic disease to distant organs (recurrence at 30 months of follow-up in the form of multiple lung metastasis) and other to lymph nodes who is alive and disease-free. Three patients were diagnosed with contralateral pheochromocytoma during the follow-up, admitted as a new primary lesion, in context of a known genetic syndrome.

Conclusion: The results of our retrospective study show that adrenalectomy is a safe, effective and a low morbidity procedure. However, the organization of surgical, anesthetic and medical teams experienced in this type of pathology is fundamental for perioperative management.