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[Coexisting pheochromocytoma and renal artery stenosis]
1Department of Urology, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025.
Objective:
To improve the diagnosis of coexisting pheochromocytoma and renal artery stenosis.
Method:
Four patients with coexisting pheochromocytoma and renal artery stenosis were treated.
Result:
After removal of the pheochromocytoma, the blood pressure became normal in two patients combined with resection of kidney with renal artery stenosis, and one patient with local adhesion loosened. The hypertension, however, persisted in another patient after the resection of pheochromocytoma even though the long segment of renal artery stenosis was relieved.
Conclusion:
After pheochromocytoma was diagnosed with its known position, coexisting renal artery stenosis should be suspected according to one of the following conditions: (1) Vascular murmurs are noted at the area of the upper abdomen or back; (2) One of the kidneys becomes less sized; (3) Using the inhibitor of receptor alpha only has no effect lowering blood pressure and it is necessary to add the inhibitor of angiotension; (4) Postoperative hypertension does not resolve when no remaining pheochromocytoma is present. the renal artery stenosis can be reversed after both removal of pheochromocytoma and loosening of adhesion in case of stenosis due to the pressure of the tumor and adhesion caused renal artery angling and local stricture. Extensive stenosis or closure, however, can not be corrected with severe atrophy of renal parenchyma due to pheochromocytoma, and the resection of kidney should be indicated.