Feocromocitoma bilateral: cirugía laparoscópica en dos casos / Bilateral pheochromocytoma: laparoscopic adrenalectomy in 2 cases

Laparoscopic adrenalectomy, if done by skilled surgeons, is now the first choice for treating most adrenal tumors, including bilateral pheochromocytoma. We report two women, aged 35 and 34 years old, with bilateral adrenal pheochromocytoma successfully excised by laparoscopic surgery. Both had severe hypertension, high urinary catecholamine values (epinephrine + norepinephrine: 528 and 1083 ug/24h) and bilateral adrenal tumors at CT scan. After 4 weeks of doxazosin treatment, a laparoscopic transperitoneal adrenalectomy was done (Gugner's technique), with surgical times of 7 and 5 hours respectively. Both patients received hydrocortisone and only the second one required one unit of packed cells. Postoperative evolution was uneventful and both patients were discharged at the fifth postoperative day. At two months of follow up, both patients are asymptomatic and normotensive

Neoplasia endócrina múltipla IIa e gestaçäo / Multiple endocrine neoplasia type IIa and pregnancy

Multiple endocrine neoplasia typella (Sipple Syndrome) is characterized by the presence of medullary thyroid carcinoma (MTC), pheochromocytoma and parathyroid hyperplasia. Although this is a rare tumor, its study is extremely relevant because its autosomal dominant type of inheritance requires familial screening. This is a report of a 35-year old pregnant woman with signs and symptoms involving arterial hypertyension, cephalea and palpitation. Her medical history included right adrenalectomy due to a phenochromocytoma and aspirative needle biopsy of thyroid sugesting MTC. In this pregnancy the patient received Prazosin and was later submitted to left adrenalectomy at 23 weeks of gestation. Histopathologic examination reveaaled a pheochromocytoma. The clinical picture became acute again stating on the 31 st week of gestation, requiring the use of Prazosin. Gestation was interrupted by cesarian section during yhe 34t week due to fetal sulfering. The infant's condition at birth was regular and recovery was good. During the late postpartum period, the patient was submited to toal thyroidectomy and left inferior parathyroidectomy. Histopathologic examination revealed MCT and parathyroid hyperplasia

Feocromocitoma del órgano de Zuckercandl

Se presenta una mujer de 23 años con hipertensión arterial, cefalea, visión borrosa, palpitaciones y masa hipogástrica, a quien se le hizo diagnóstico de feocromocitoma del órgano de Zuckercandl. Durante el acto operatorio desarrolla arritmia cardíaca y colapso circulatorio. Se revisa el tema de feocromacitoma haciendo énfasis en el originado en el órgano de Zuckercandl.

Precipitous hypotension after nifedipine in pheochromocytoma: report of 2 cases.

Two patients with pheochromocytoma initially responded to oral or sublingual nifedipine with marked reduction in systolic blood pressure (range 50-160 mmHg) without concomitant increment in the heart rate or clinical consequences. This could possibly be due to the combination of hypovolemia and negative inotropism.