title: Surgical analysis of pediatric and adolescent sporadic pheochromocytoma: single center experience.
abstract: BACKGROUND
  The aim of this study is to review our experience with sporadic pheochromocytoma in pediatrics and adolescents focusing upon surgical approach, incidence of malignancy, and recurrence rate.
  
  
  METHODS
  Between 1990 and 2007, 8 pediatric patients were diagnosed with sporadic pheochromocytoma. Demographic data, clinical and radiological findings, laboratory profile, preoperative preparation, surgical approach, operative findings, postoperative course as well as pathologic diagnosis of the removed specimen were reviewed.
  
  
  RESULTS
  Mean age of presentation was 13.1 ± 4.7 years. Five patients had right-sided masses, 1 harbored left-sided mass, and bilaterality was observed in 2 with mean size of 5.7 ± 1.3 cm. Computed tomography showed no evidence of local infiltration, regional lymphadenopathy or distant metastasis in all patients but two. Six masses were excised through thoraco-abdominal approach, 3 were removed laparoscopically, while percutaneous alcohol ablation was adopted for the last. We had one postoperative death (12.5%:1/8), and the remaining 7 patients were followed for a mean of 8.6 ± 3 years. Five patients never had recurrence. Bilateral recurrence developed in 2 patients, where they were safely excised in one patient and was a part of disseminated disease in the other. Malignant nature of the disease was proved in 2 patients and showed poor survival.
  
  
  CONCLUSIONS
  Under adequate anesthetic control, pediatric pheochromocytoma could be safely managed through both the open and laparoscopic approaches. Advanced radiological stage would suggest the malignant nature of the disease with dismal outcome. Long-term follow-up is warranted for possibility of delayed curable recurrence.
authors.affiliation: Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. y_osman99@yahoo.com
authors.forename: Yasser
authors.initials: Y
authors.lastname: Osman
authors.forename: Naser
authors.initials: N
authors.lastname: Hussein
authors.forename: Osama
authors.initials: O
authors.lastname: Sarhan
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Shorrab
authors.forename: Mohamed
authors.initials: M
authors.lastname: Dawaba
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Ghoneim
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D000768:Anesthesia, General / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010673:Pheochromocytoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies