Cardiac pheochromocytoma (report of 3 cases) / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the clinical features, diagnosis and treatment of cardiac pheochromocytoma. Methods The clinical data of 3 cases (2 males and 1 female) who were 17,40 and 35 years old,respectively,were analyzed.They all presented with headache, sweating, palpitations and hypertension.Before operation 24-hour urinary catecholamine excretion was examined for the 17-year-old man and the woman twice with the results as follows.In the 17-year-old man,epinephrine (E) was 1.84,150.28 ?g/24h (normal range,4.08?2.34 ?g/24h);norepinephrine (NE)734.77,508.00 ?g/24h (normal range,28.67?11.98 ?g/24h);dopamine (DA)823.00,620.31 ?g/24h (normal range,225.76?104.83 ?g/24h).In the woman,E was 12.40,16.03 ?g/24h;NE1778.92,1243.96 ?g/24h;DA1517.47,926.89 ?g/24h.All the 3 patients had positive result with Tc-99m-Otretide scintigraphy,and all underwent orthotopic excision of tumors under cardiopulmonary bypass. Results During operation,the tumors of 2-5 cm in size were seen to lie at the base of the aorta,left atrium and interauricular septa respectively,and grew invasively like carpet,thus were difficult to remove. Postoperative pathology of 3 cases confirmed the diagnosis of cardiac pheochromocytoma.After follow-up for 8-24 months,3 cases had a mean fall of 30 mmHg in systolic pressure and 20 mmHg in diastolic pressure,respectively.The 17-year-old man had decline in cardiac function that was proved by Tc-99m-Otretide scintigraphy test;another male patient suffered from arrhythmias 1 month after operation,and was found to have tumor remains by PET test.Myocardial infarction occurred in the female patient. Conclusions Cardiac pheochromocytoma is a rare tumor, and its diagnosis is rather difficult and complex.Surgical excision is very difficult with the possibility of complications.