The management of benign and malignant pheochromocytoma and abdominal paraganglioma.
OBJECTIVE
To report treatment and outcome in patients with malignant and benign pheochromocytoma and abdominal paraganglioma.


METHODS
Review of clinical and therapeutic features in 85 patients with pheochromocytoma or abdominal paraganglioma between 1976 and 1999.


RESULTS
Thirty-nine of 85 patients presented with symptoms other than classical paroxysmal attacks. Paragangliomas were more often malignant (7/15) than pheochromocytomas (7/70). No recurrences have occurred in 71 patients with tumours initially classified as benign after a median follow-up time of 144 months (range 7-287). Nine of 14 patients with tumours classified as malignant have developed metastasis and/or local recurrence. Treatment of malignant tumours with cyclophosphamide, vincristine and dacarbazine (CVD) improved or stabilised the disease in three of four patients.


CONCLUSIONS
Life long follow-up of patients with benign pheochromocytoma is not necessary. Combination chemotherapy (CVD) is a valid option in the treatment of malignant pheochromocytomas and abdominal paragangliomas.
Edström Elder
E
E
Department of Surgery, Karolinska Hospital, SE-171 76, Stockholm, Sweden. Elisabeth.Edstrom-Elder@ks.se
Hjelm Skog
A-L
AL
Höög
A
A
Hamberger
B
B
D000008:Abdominal Neoplasms / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000473:pathology / Q000628:therapy*; D010673:Pheochromocytoma / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome