Vol 60, No 3 (2009)
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Published online: 2009-04-27

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Pheochromocytoma in 8-year observation at a single endocrinological center in Wroclaw

Grażyna Bednarek-Tupikowska, Barbara Bucyk, Jacek Daroszewski, Bożena Bidzińska-Speichert, Anna Bohdanowicz-Pawlak, Jadwiga Szymczak, Włodzimierz Bednorz, Franciszek Podgórski, Elżbieta Zaręba-Bogdał, Justyna Kuliczkowska-Płaksej, Agnieszka Lenarcik, Alicja Filus, Marcin Kałużny, Eliza Kubicka, Joanna Syrycka, Małgorzata Tupikowska, Oskar Lizurej, Marek Bolanowski, Andrzej Milewicz
Endokrynol Pol 2009;60(3):189-198.


Introduction: Pheochromocytoma is rare tumor with a highly variable clinical presentation. This report provides clinical picture, efficiency of diagnostics and treatment of pheochromocytoma in 8-years in the endocrinological center in Wroclaw.
Material and methods: The records of 37 patients with pheochromocytoma were identified, who were treated in 2000-2007 in the Department of Endocrinology, Diabetology and Isotope Treatment in Wroclaw. There were 23 women (age 23-75 year) and 14 men (age 17-74). We studied frequency of clinical signs, usefulness of diagnostic methods and efficacy of treatment.
Results: The duration of the clinical history ranged from 2 months to 16 years. The most frequent symptoms were: hypertension paroxysmal and constant, palpitations, headache, sweating and anxiety. The most sensitive diagnostic method was increased concentration of urinary metanephrine in 24-hour urine. Computed tomography was the most widely used method for tumor localization. Adrenal pheochromocytoma was detecting by CT in all patients, predominated in right adrenal, in 1 case in urinary bladder. Surgery caused remission of hypertension in 59%, improvement in 26.8%, and no changes in 13.9% of patients. Malignancy was reported in 2 cases, 1 woman died after surgery. MEN 2A occur in 21.6%.
Conclusions: The diagnosis of pheochromocytma is usually made after long duration of the disease. The study confirms that clinical presentation of pheochromocytoma is variable and nonspecific, this finding makes the diagnosis very difficult. The most typical symptom is paroxysmal hypertension, which is present only in 40%, other symptoms are nonspecific. The measurement of 24-hour urinary metanephrines was the best indicator. CT was almost always successful in localizing the tumor. Patients with pheochromocytoma should be consider for other endocrine diseases especially medullary carcinoma, primary hyperparathyroidism and other component of MEN 2A.

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