Advertisement
Research Article| Volume 7, ISSUE 1, P1-21, January 1991

Pheochromocytoma

  • Brahm Shapiro
    Correspondence
    Address reprint requests to: Brahm Shapiro, MB, ChB, PhD, Divison of Nuclear Medicine, University of Michigan Medical Center, 1500 E. Medical Center Drive, UH B1 G505D, Box 0028, Ann Arbor, MI 48109
    Affiliations
    Professor of Internal Medicine, Department of Internal Medicine and Division of Nuclear Medicine, University of Michigan Medical Center, Ann Arbor, Michigan
    Search for articles by this author
  • Milton D. Gross
    Affiliations
    Professor of Internal Medicine, Department of Internal Medicine and Division of Nuclear Medicine, University of Michigan Medical Center; and Chief, Nuclear Medicine Services The Department of Veterans Affairs Medical Center, Ann Arbor, Michigan
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.
      A rational management of pheochromocytoma is outlined, consisting of clinical suspicion, biochemical confirmation, radiologic localization, meticulous preoperative, interoperative, and postoperative monitoring, and pharmacologic intervention. The principles for achieving surgical cure (possible in 90% of cases) are described, as is the pharmacologic, chemotherapeutic, and radiotherapeutic management of malignant or inoperable tumors.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Critical Care Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Allison D.J.
        • Brown M.J.
        • Jones D.H.
        • et al.
        Role of venous sampling in locating a phaeochromocycoina.
        Br Med J. 1983; 236: 1122
        • Averbuch S.D.
        • Steakiey O.S.
        • Young R.C.
        • et al.
        Malignant pheochromocytoma: Effective treatment with a combination of cyclophosphamide, vincristine, and dacarbazine.
        Ann Intern Med. 1988; 109: 267
        • Bergman S.M.
        • Sears H.F.
        • Javadpour N.
        • et al.
        Postoperative management of patients with pheochromocytoma.
        J Urol. 1978; 120: 109
        • Bittar D.A.
        Unsuspected phaeochromocytoma.
        Can Anaesth Soc J. 1982; 29: 183
        • Bravo E.L.
        • Gifford R.W.
        Pheochromocytoma: Diagnosis, localization and management.
        N Engl J Med. 1984; 311: 1298
        • Drasin H.
        Treatment of malignant pheochromocytoma.
        West J Med. 1978; 128: 106
        • Egglin T.K.
        • Hahn P.F.
        • Stark D.D.
        MRI of the adrenal glands.
        Semin Roentgenol. 1988; 23: 280
        • Engelman K.
        • Horwitz D.
        • Jequier E.
        • et al.
        Biochemical and pharmacologic effects of alpha-methyltyrosine in man.
        J Clin Invest. 1968; 47: 577
        • Feldman J.M.
        Treatment of metastatic pheochromocytoma with streptozocin.
        Arch Intern Med. 1983; 143: 1799
        • Flanigan R.C.
        • Wittman R.P.
        • Huhn R.G.
        • et al.
        Malignant pheochromocytoma of urinary bladder.
        Urology. 1980; 16: 386
        • Francis I.R.
        • Glazer G.M.
        • Shapiro B.
        • et al.
        Complementary roles of CT and I-MIBG scintigraphy in diagnosing pheochromocytoma.
        Am J Radiol. 1983; 141: 719
        • Gilsanz F.J.
        • Luengo C.
        • Conejero P.
        • et al.
        Cardiomyopathy and phaeochromocytoma.
        Anaesthesia. 1983; 38: 888
        • Glowniak J.V.
        • Shapiro B.
        • Sisson J.C.
        • et al.
        Familial extra-adrenal pheochromocytoma: A new syndrome.
        Arch Intern Med. 1985; 145: 257
        • Hamaji M.
        • Oka N.
        • Tashiro C.
        • et al.
        Anaesthetic management with morphine in phaeochromocytoma.
        Can Anaesth Soc J. 1984; 31: 681
        • Hoefnagel C.A.
        • Voute P.A.
        • deKraker J.
        • et al.
        Radionuclide diagnosis and therapy of neural crest tumours using iodine-131 metaiodobenzylguanidine.
        J Nucl Med. 1987; 28: 308
        • Hoffman B.B.
        • Lefkowitz R.J.
        Alpha-adrenergic receptor subtypes.
        N Engl J Med. 1980; 302: 1390
        • Hull C.J.
        Phaeochromocytoma. Diagnosis, preoperative preparation and anaesthetic management.
        Br J Anaesth. 1986; 58: 1453
        • Humble R.M.
        Phaeochromocytoma, neurofibromatosis and pregnancy.
        Anaesthesia. 1967; 22: 296
        • lones D.I.
        • Durning P.
        Pheochromocytoma presenting as an acute abdomen: Report of two cases.
        Br Med J. 1985; 291: 1267
        • lones R.M.
        • Hill A.B.
        Severe hypertension associated with pancuronium in a patient with phaeochromocytoma.
        Can Anaesth Soc J. 1981; 28: 394
        • Leak D.
        • Carroll J.J.
        • Robinson D.C.
        • et al.
        Management of phaeochromocytoma during pregnancy.
        Can Med Assoc J. 1977; 116: 371
        • MacDonald W.N.
        • Doll W.A.
        • Schmidt N.
        • et al.
        Intravenous nitroglycerin control of blood pressure during resection of phaeochromocytoma.
        Can Anaesth Soc J. 1982; 29: 108
        • Manger W.M.
        • Gifford Jr., R.W.
        • Hoffman B.B.
        Pheochromocytoma: A clinical and experimental overview.
        Curr Probl Cancer. 1985; 9: 1
        • Maze M.
        • Matson D.M.
        Inhalation Anaesthesiology. WB Saunders, Philadelphia1983: 310-318
        • McManus B.M.
        • Fleury T.A.
        • Roberts W.C.
        Fatal catecholamine crisis in pheochromocytoma, curable cause of cardiac arrest.
        Am Heart J. 1981; 102: 930
        • Meeke R.I.
        • O’Keefe J.D.
        • Gafney J.D.
        Phaeochromocytoma removal and postoperative hypoglycaemia.
        Anaesthesia. 1985; 40: 1093
        • Mihm F.G.
        Pulmonary artery pressure monitoring in patients with pheochromocytoma.
        Anesth Analg. 1983; 62: 1129
        • Mitty H.A.
        Embryology, anatomy, and anomalies of the adrenal gland.
        Semin Roentgenol. 1988; 23: 271
        • Modlin I.M.
        • Farndon I.R.
        • Shepherd A.
        • et al.
        Phaeochromocytomas in 72 patients: Clinical and diagnostic features, treatment and long-term results.
        Br J Surg. 1979; 66: 456
        • Navaratnarajah M.
        • White D.C.
        Labetolol and phaeochromoctyoma.
        Br J Anaesth. 1984; 56: 1179
        • Nicholson J.P.
        • Vaughn E.D.
        • Pickering T.G.
        • et al.
        Phaeochromocytoma and prazosin.
        Ann Intern Med. 1983; 99: 477
        • Page L.B.
        • Raker J.W.
        • Berberich F.R.
        Pheochromocytoma with predominant epinephrine secretion.
        Am J Med. 1969; 47: 648
        • Pearse A.G.E.
        • Polak J.M.
        Endocrine tumors of neural crest origin: Neuroblastomas, apudomas and the APUD concept.
        Med Biol. 1974; 52: 3
        • Pinaud M.
        • Desjars P.
        • Tasseau F.
        • et al.
        Preoperative acute volume loading in patients with phaeochromocytoma.
        Crit Care Med. 1985; 13: 460
        • Rosei E.A.
        • Brown J.J.
        • Lever A.F.
        • et al.
        Treatment of phaeochromocytoma and of clonidine withdrawal hypertension with labetalol.
        Br J Clin Pharmacol (suppl). 1976; 3: 809
        • Rossi P.
        • Young I.S.
        • Panke W.F.
        Techniques, usefulness, and hazards of arteriography of pheochromocytoma; Reivew of 99 cases.
        JAMA. 1968; 205: 547
        • Schultz C.L.
        • Haaga J.R.
        • Fletcher B.D.
        • et al.
        Magnetic resonance imaging of the adrenalglands: A comparison with computed tomography.
        AJR. 1984; 143: 1235
        • Scott Jr., H.W.
        • Reynods V.
        • Green N.
        • et al.
        Clinical experience with malignant pheochromocytomas.
        Surg Gynecol Obstet. 1982; 154: 801
        • Serfas D.
        • Shobak D.M.
        • Lorell B.H.
        Phaeochromocytoma and hypertrophic cardiomyopathy: Apparent suppression of symptoms and noradrenaline secretion by calcium-channel blockade.
        Lancet. 1983; ii: 711
        • Shapiro B
        • Fig LM
        The management of pheochromocytoma.
        in: Barkan A Medical Therapy of Endocrine tumors. Endocrinol Metab Clin North Am. 18. 1990: 443
        • Shapiro B.
        • Gross M.D.
        Disorders of the Adrenal Medulla and Sympathetic Nervous System (chapter 424).
        in: Kelley W.N. Textbook of Internal Medicine. JB Lippincott, 1988: 2197-2202
        • Shapiro B.
        • Sisson J.C.
        • Kalff V.
        • et al.
        The location of middle mediastinal pheochromocytomas.
        J Thorac Cardiovasc Surg. 1984; 87: 816
        • Shapiro B.
        • Sisson J.C.
        • Lloyd R.
        • et al.
        Malignant pheochromocytoma: Clinical, biochemical and scintigraphic characterization.
        Clin Endocrinol. 1984; 20: 189
        • Sheps S.G.
        • Jiany N.
        • Klee G.G.
        • et al.
        Recent developments in the diagnosis and treatment of pheochromocytoma.
        Mayo Clin Proc. 1990; 65: 88
        • Sisson J.C.
        • Frager M.S.
        • Valk T.W.
        • et al.
        Scintigraphic localization of pheochromocytoma.
        N Engl J Med. 1981; 305: 12
        • Sisson J.C.
        • Shapiro B.
        • Beierwaltes W.H.
        • et al.
        Radiopharmaceutical treatment of malignant pheochromocytoma.
        J Nucl Med. 1984; 24: 197
        • Sisson J.C.
        • Shapiro B.
        • Beierwaltes W.H.
        Scintigraphy with 1-131 MIBG as an aid to the treatment of pheochromocytomas in patients with the MEN-2 syndromes.
        Henry Ford Med J. 1984; 32: 254
        • Sloand E.M.
        • Taylor Thompson B.
        Propranolol-induced pulmonary edema and shock in a patient with pheochromocytoma.
        Arch Intern Med. 1984; 144: 173
        • Solares G.
        • Ramos F.
        • Martin-Duran R.
        • et al.
        Amiodarone, phaeochromocytoma and cardiomyopathy.
        Anaesthesia. 1986; 41: 186
        • Sumikawa K.
        • Hirano H.
        • Amakata Y.
        • et al.
        Mechanism of the effect of droperidol to induce catecholamine efflux from the adrenal medulla.
        Anesthesiology. 1985; 62: 17
        • Suzukawa M.
        • Michaels I.A.L.
        • Ruzbarsky J.
        • et al.
        Use of isoflurane during resection of pheochromocytoma.
        Anesth Analg. 1983; 62: 100
        • Vater M.
        • Achola K.
        • Smith G.
        Catecholamine responses during anaesthesia for phaeochromocytoma.
        Br J Anaesth. 1983; 55: 357
        • Wilber J.F.
        • Turtle J.R.
        • Crane N.A.
        Inhibition of insulin secretion by a phaeochromocytoma.
        Lancet. 1966; 2: 733
        • Yeh H-C.
        Ultrasonography of the adrenals.
        Semin Roentgenol. 1988; 23: 250