Skip to main content
Log in

Regressive changes in phaeochromocytomas and paroxysmal hypertension

  • Research Article
  • Published:
Central European Journal of Medicine

Abstract

Introduction

Pheochromocytomas may cause life-threatening episodes of arterial hypertension and surgical treatment is obligatory following proper general medical preparation.

Material and methods

There were 63 patients in years 2006–2011 operated in the department due to pheochromocytoma. The group comprised 38 women and 25 men of the age range 16–80, mean 44,7. All the specimen were analyzed in pathological examination. The regressive changes that were found were subsequently compared with the clinical course of the pheochromocytoma both in the preoperative period and at the time of the surgery.

Results

There were 44 laparoscopic adrenalectomies performed, out of which 5 resulted in conversions to open surgery, while 19 patients were operated primarily via open access. The indications for the open procedures: extraadrenal tumors, fibrotic-infiltrative lesions suggestive of malignancy, vast intratumoral extravasation, and respiratory failure. In all the postoperative specimens pheochromocytomas were found. In 29 cases intratumoral haemorrhages were observed, in 17 — tumoral necrosis at different stages, and in 3 cases posthaemorrhagic cystis. In 6 cases the lesions were accompanied by major fibrosis and hyalinization.

Conclusions

There is a statistically significant relationship between regressive changes observed within phaeochromocytomas and a reduction of paroxysmal hypertension at the time of adrenalectomy (p=0,012).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Shen WT, Grogan R, Vriens M, Clark OH, Duh QY. One hundred two patients with pheochromocytoma treated at a single institution since the introduction of laparoscopic adrenalectomy. Arch Surg. 2010;145(9):893–897

    Article  PubMed  Google Scholar 

  2. Masamune T, Matsukawa T. Pheochromocytoma. Masui. 2010;59(7):883–886

    PubMed  Google Scholar 

  3. Otto M., Dzwonkowski J, Januszewicz A, Pęczkowska M, Kański A, Kasperlik-Załuska A, Rosłonowska E, Szmidt J. Przełom nadciśnieniowy w chirurgicznym leczeniu guzów nadnerczy i postępowanie w pooperacyjnej hipotensji. Pol Przeg Chir 2010;82(4):347–367

    Google Scholar 

  4. Manger WM, Gifford RW. J Clin Hypertens (Greenwich). Pheochromocytoma. 2002;4(1):62–72

    Google Scholar 

  5. Yau JS, Li JK, Tam VH, Fung LM, Yeung CK, Chan KW, Lee KF, Lee KF, Cheung WS, Yeung VT, Yuen YP, Kwan WK. Pheochromocytoma in the Hong Kong Chinese population. Hong Kong Med. J 2010;16(4):252–256

    PubMed  Google Scholar 

  6. Mahovic D, Lakusic N, Slivnjak V. Tako-Tsubo syndrome: A diagnostic challenge CEJMed 2009;4(4):536–538

    Google Scholar 

  7. Kim S, MD; Yu A, MD; Filippone LA, BA; Kolansky DM, MD; Raina A, MD. Inverted-Takotsubo Pattern Cardiomyopathy Secondary to Pheochromocytoma: A clinical case and literature review. Clin. Cardiol. 2010;33(4)200–205

    Article  PubMed  Google Scholar 

  8. Habib M, PhD MD, Tarazi I, MD, and Batta M, MD. Arterial embolization for ruptured adrenal pheochromocytoma. Curr Oncol. 2010;17(6):65–70

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. May EE, Beal AL, Beilman GJ. Traumatic hemorrhage of occult pheochromocytoma: a case report and review of the literature. Am Surg. 2000;66(8):720–724

    CAS  PubMed  Google Scholar 

  10. Brown H, Goldberg PA, Selter JG, Cabin HS, Marieb NJ, Udelsman R, Setaro JF. Hemorrhagic pheochromocytoma associated with systemic corticosteroid therapy and presenting as myocardial infarction with severe hypertension. J Clin Endocrinol Metab. 2005;90(6):3803–3804

    Google Scholar 

  11. Kobayashi T, Iwai A, Takahashi R, Ide Y, Nishizawa K, Mitsumori K. Spontanegous rupture adrenal pheochromocytoma: review and analysis of prognostic factors. J Surg Oncol. 2005;90(1):31–5

    Article  PubMed  Google Scholar 

  12. Šakić K, Kvolik S, Grljušić M, Vrbanović V, Prilć L. Perioperative hypertension in phaeochromocytoma patients undergoing adrenalectomy CEJMed 2007; 2(4):470–480

    Google Scholar 

  13. Chien HP, Chang YS, Hsu PS, Lin JD, WU KH, Chang HL, Chuang CK, Tsuei KH, Hsueh C. Adrenal Cystic Lesions: A clinicopatholigical analysis of 25 cases with proposed histogenesis and review of the literature. Endocr Pathol. 2008 19:274–281

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Łukasz Zapała.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pogorzelski, R., Toutounchi, S., Fiszer, P. et al. Regressive changes in phaeochromocytomas and paroxysmal hypertension. cent.eur.j.med 9, 663–666 (2014). https://doi.org/10.2478/s11536-013-0308-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2478/s11536-013-0308-9

Keywords

Navigation