47 years of phaeochromocytomas

Thirty three patients with phaeochromocytomas had surgery in St. Vincent's Hospital between 1950 and 1997. 32 patients had hypertension, 32 had palpitations and 30 had excessive sweating. All patients had at least one of these cardinal symptoms. Diagnostic tests changed over this period. In the early cases the phentolamine test was used, later diagnosis was confirmed by measurement of urinary VMA and catecholamines. IVP, CT, ultrasound or MIBG scanning were used to locate the tumours. Before 1967, 3 of 17 patients died peri-operatively, 2 of these from strokes and one from pulmonary embolism. Since then, all patients have survived surgery. Four of the women had phaeochromocytomas diagnosed during pregnancy. Two of the 33 patients had tumours that were malignant, the remainder being benign. One patient has died from metastatic disease. This series illustrates the changing trends in the surgical management of phaeochromocytomas.