Clinical Analysis Of 41 Patients Of Pheochromocytoma

[Objective]T o study retrospectively the manifestation,diagnosis and treatment for pheochromocytoma.[Methods]W e reviewed 41 cases of a pheochromocytoma(14 men and 27 women) treated in department of Urology,the first affiliated Hospital,Zhejiang University School of medicine from 2006-2008,studying their manifestation,accessory examination,preoperative preparation,operation and follow-up.In this series,31 patients complained hypertension,11 of whom had a paroxysmal attack and the rest had a persistent and paroxysmal one.Among the 10 patients without hypertension,4 with adrenal mass were diagnosed through imageological methods,and 2 had silent forms.Besides there were other manifesion such as headache,vertigo, palpitation,perspiration and chest distress,etc.Blood catercholamine assay was done in 30 patients,with 25(83%)positive.All the patients had B-ultrasonography scan and its accuracy rate was 98%.Computerized tomography scan and magnetic resonance imaging were done in 29 patients and 12 patient repectively and both the positive rates were 100%.Other examinations include emission computed tomography(1 patient) and positron emmision tornography scan(1 patient).Hypotensor(phentolamine,prazosin) was administered to 27 patients 1-2 weeks before operations.Calcium antagonist(nifedipine) was administered to the patients whose blood pressure was not under control,andβ-bolckers were used in those with tachycardia.500ml dextranum injection and glucose saline injection were intravenously drip in 33 patients 3-12days before operations.[Results]All the patients have undergone operations,33 of whom were performed openly,and the rest laparoscopically.No patient died in perioperative period.38 patients of adrenal pheochromocytomas were comfirmed pathologically,with 33 cases of monolateral tumors(16 left,17right),and 6 cases of bilateral ones.1 of these patient was diagnosed as von Hippel-Lindau disease and had a family history.Ectopic pheochromocytomas were also found in 2 patients.31 patients were followed up for 3months to 3 years and still alive.4 recurrent patients with one of them had metastaisis were confirmed.2 patients have been hospitalized and undergone operations.[Conclusions]W e should pay more attention to pheochromocytoma,to prevent misdiagnosis and missed diagnosis.Preoperative treatments(hypertension control,fluid infusion and complication treatment)were important to the safety of patients.Operation was still a main remedy for the disease.Malignant pheochromocytoma calls for early diagnosis and multi-modality treatment.