Analysis of diagnosis and treatment on asymptomatic adrenal pheochromocytoma of 33 cases / 中国医师进修杂志

ABSTRACT

Objective To improve the diagnosis and treatment of asymptomatic adrenal pheochromocytoma. Method The clinical data of 33 patients with asymptomatic adrenal pheochromocytoma were reviewed. Results All the patients were not preut with typical signs and symptoms of pheochromocytoma, 16 patients were found adrenal mass by routine physical examination, 15 patients presented with superior abdominal or flank pain, 1 patient was fever and 1 patient was diarrhea. Most of patients were prent with round mass with low density in the center of the tumor,5 patients had elevated level of plasma epinephrine and norepinephrine (16% ,5/31),24 hours urine CA and VMA were elevated in 6 patients (24%, 6/25) and 5 patients (20%, 5/25) respectively, 26 patients who were suspected pheochromocytoma preoperatively were treated with α-adrenergic blockade (prazosin) to control the blood pressure or with intravenous colloid fluids and blood transfusion to expand intravascular volume before operation. The tumors were removed successfully in 32 patients, and biopsy was done in 1 patient because of the serious invasion to the vena cava by the tumor. All the patients were diagnosed pheochromocytoma histopathologically,and followed up for 1 month to 7 years, no tumor recurrence. Conclusions The patients with asymptomatic adrenal pheochromocytoma have lower catecholamine excretion in their plasma and urine. Combination of modem imaging examinations are useful methods to diagnose asymptomatic adrenal pheochromocytoma. To lower the risk of operation, the control of blood pressure and the expanding of intravascular volume are important for the patients with huge adrenal mass or typical suspected appearance of pheochromocytoma.