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[Malignant pheochromocytoma: diagnosis and treatment]
1Department of Urology, Jinan General Hospital of People's Liberation Army, Jinan 250031.
Objective:
To review the experience with the diagnosis and treatment of malignant pheochromocytoma.
Methods:
Between 1986 and 1996, 7 patients with malignant pheochromocytoma were analysed.
Results:
Compared with benign pheochromocytoma of adrenal gland, the malignant one usually exceeded 7.0 cm in diameter, irregular in shape, invading the surrounding tissue and the normal structure of the effected adrenal gland disappeared. Bleeding and necrotic area were seen in tumor mass, even seemed as a cystic lesion with thick wall. In some patients, blood catecholamine and urine VMA significantly elevated without hypertension. The separating phenomenon and progressive weight loss, accelerated ESR were characteristics of malignant pheochromocytoma.
Conclusions:
In some patients with malignant pheochromocytoma, histological findings are not consistent with their biological behaviors. Follow-up studies is mandatory in malignant pheochromocytoma as well as in benign one. Recurrence and/or metastasis after operation often occur in patients with malignant pheochromocytoma. In addition to early diagnosis and surgery, radiotherapy of tumor bed and systematic chemotherapy should be emphasized.