Risk of catecholamine crisis in patients undergoing resection of unsuspected pheochromocytoma

Gina Song, Bonnie N. Joe, Benjamin M. Yeh, Maxwell V. Meng, Antonio C. Westphalen, Fergus V. Coakley

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Purpose: To report the risk of catecholamine crisis in patients undergoing resection of unsuspected pheochromocytoma. Materials and Methods: Over a four-year period, we retrospectively identified four patients who underwent resection of adrenal pheochromocytoma in whom the diagnosis was unsuspected based on preoperative clinical, biochemical, and imaging evaluation. Results: None of the patients exhibited preoperative clinical features of catecholamine excess. Preoperative biochemical screening in two patients was normal. CT scan performed in all patients demonstrated a nonspecific enhancing adrenal mass. During surgical resection of the adrenal mass, hemodynamic instability was observed in two of four patients, and one of these two patients also suffered a myocardial infarct. Conclusion: Both surgeons and radiologists should maintain a high index of suspicion for pheochromocytoma, as the tumor can be asymptomatic, biochemically negative, and have nonspecific imaging features. Resection of such unsuspected pheochromocytomas carries a substantial risk of intraoperative hemodynamic instability.

Original languageEnglish (US)
Pages (from-to)35-40
Number of pages6
JournalInternational Braz J Urol
Volume37
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • Adrenal gland neoplasms
  • Catecholamines
  • Imaging
  • Pheochromocytoma
  • Surgery

ASJC Scopus subject areas

  • Urology

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