[Adrenal gland pheochromocytomas. Apropos of 35 operated patients].
Thirty-five patients (20 female and 15 male, mean age = 47 years) operated on for an adrenal pheochromocytoma were reviewed. Catecholamine excessive production was symptomatic in 33 patients (94%). Urinary excretion of vanyl-mandelic acid, catecholamines and metanephrine was abnormal in 84%, 75% and 90% of cases, respectively. Tumor was presumed benign (no metastasis) in 31 cases. Sensitivity of CT scan (n = 35) and magnetic resonance imaging (n = 13) was 100%. Meta-iodo-benzylguanidine scan (n = 19) always recognized the main tumor, but did not visualize 1 second tumor in 1 patient and 1 metastasis in 1 other patient. An anterior intraperitoneal approach was performed in all cases. Operative mortality rate was 5.7%. In the last 15 patients, systematic preoperative treatment by prazosine did not lead to fall in rates of peroperative arrythmia and hemodynamic disorders. Twenty-two of 25 (88%) hypertensive patients remained normotensive without medication postoperatively. The risk of undiagnosed pheochromocytoma and problems in resection of large right-sided tumors are discussed.
Chapuis
Y
Y
Clinique Chirurgicale, Hôpital Cochin, Paris.
Sauvanet
A
A
Pras-Jude
N
N
Icard
P
P
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011224:Prazosin / Q000627:therapeutic use; D011300:Preoperative Care; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D011224:Prazosin
Phéochromocytomes surrénaliens. A propos de 35 malades opérés.