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 language | English (US) |
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Pages (from-to) | 35-40 |
Number of pages | 6 |
Journal | International Braz J Urol |
Volume | 37 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2011 |
Externally published | Yes |
Keywords
- Adrenal gland neoplasms
- Catecholamines
- Imaging
- Pheochromocytoma
- Surgery
ASJC Scopus subject areas
- General Medicine