Retrospective analysis of patients clinical manifestations before and after pheochromocytoma surgery.
OBJECTIVE
A retrospective analysis of presurgical clinical picture and blood pressures of 34 patients with histologically verified pheochromocytoma. Assessment of clinical state, blood pressure and prognosis in the course of patients control hospitalizations from 2001 to 2002.


METHODS
The study was designed as a synoptic one, based on a retrospective analysis of 34 patients records with histologically verified pheochromocytoma (26 women and 8 men). Our assessments of clinical symptomatology, maximum paroxysmal hypertension values, average blood pressure values in patients with persistent arterial hypertension, arterial hypertension grade and circadian index were based on patients records. Patients epinephrectomies were followed during their control hospitalizations to assess their clinical state. Their blood pressures were evaluated by means of their circadian monitoring.


RESULTS
From the 34 patients, 21 were diagnosed with solitary pheochromocytomas. The circadian index persistence analysis prior to the surgery was associated with circadian blood pressure monitoring in 21 patients. It was lost in 57% of patients. During their control hospitalization as many as 82% of patients preserved their circadian blood pressure variability with a more than 10% decrease in the night time, 5 patients did not preserve their circadian blood pressure variability. Seven from the original 34 patients died: Three of them died from their primary disease, one 63-year old man died from shock following tumour extirpation. The death of other 3 patients was not associated with their primary disease.


CONCLUSIONS
Long-lasting survival of patients with pheochromocytoma after surgical treatment--except for those with malignant disease--was demonstrated. Although our assessment of the resulting treatment effects was positive, a long-term follow-up is inevitable because of a difficult pathologic-anatomical verification of the malignant nature of the disease as well as of the risk of tumour relapse assessment. (Tab. 1, Fig. 5, Ref 36.)
Balazovjech
I
I
IInd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia. bll@fmed.uniba.sk
Davidova
H
H
Breza
J
J
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D001794:Blood Pressure; D005260:Female; D006801:Humans; D008297:Male; D010673:Pheochromocytoma / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate