Endocrine Abstracts

Introduction: Pheochromocytomas are the most common tumours of adrenal medullary origin. The aim of this study is to describe the clinical manifestations, biochemical profile, preoperative pharmacological approach and hemodinamic outcomes in a series of patients with histologically proven pheochromocytoma treated in our center over 12 years.

Methods/design: Descriptive analysis including patients diagnosed with pheochromocytoma after histological examination. Patients with suspected tumour without histological evidence were excluded for assesment as well as those whose medical records were incomplete.

Results: Pheochromocytoma was histologically diagnosed in 11 out of 15 patients from 2002 to 2014. One patient was excluded because of incomplete medical records. There were 6 females and 5 males (F:M=1.2:1), age ranged from 27 to 80 years. Presenting form was persistent and/or refractory hypertension in 2 patients, incidental adrenal mass in 2 cases and paroxysmal hypertension crisis in 5. Two cases presented as abrupt hypertensive emergency. The most common clinical manifestations were headache (7 cases), palpitations (6 cases) and perspiration (5 patients). Type of tumour secretion: norepinephrine (5), norepinephrine and epinephrine (4), norepinephrine, epinephrine and dopamine (2). All patients underwent successful surgical removement and unilateral adrenal mass was identified in all cases (left gland in 8 cases). Median mass size was 3 (range: 1.5–10) cm. Preoperative selective alfa-blockade was performed with phenoxybenzamine in 7 cases and 4 patients received non-selective alfa-blockade with doxazosin. Beta-blockade was needed in 9 cases. Preoperative systolic blood pressure: 130 (120–140 mm Hg), diastolic blood pressure 80 (71.2–87.5 mm Hg) and heart rate: 71 (65–85 bpm). Mean time until optimal pharmacological blockade: 21 days.

Conclusions: There were no classic presenting form for pheochromocytoma in our series, although clinical history and physical findings are helpful. There wasn’t any standard approach in preoperative pharmacological blockade. Though therapeutic results were favourable, protocols for preoperative management may be considered in our center.