Diagnostic and therapeutic problems in 10 cases of pheochromocytomae

Ten cases of pheochromocytomae, of which eight were benign and two malignant have been considered. All patients presented with hypertension, either paroxysmal (7 cases) or permanent (3 cases). It is essential to emphasize that the initial symptomatology of these patients on their admission to the hospital was often atypical and misleading: in 2 cases, the symptomatology was urological, in 2 cases psychatric and in one digestive. Quantitative determination of catecholamines and their metabolites was positive in 7 cases out of 10. Retropneumoperitoneal insufflation combined with intravenous urography and tomographies provided valuable information in each case. The surgical removal of these tumours, which was unilateral and in normal position, in each case, was carried out without complications. Sudden blood pressure variations observed during the operation could be controlled without difficulty. In 6 patients, the blood pressure became normal and remained so for 4 years. In 2 other patients, the blood pressure came back to normal after the operation, but presented a slight increase 1 year later. Pheochromocytomae, which are often masked by a misleading symptomatology, must be systematically searched for in all hypertensive patients, despite the characteristics of the hypertension. Surgical removal, if done early enough, produces cure of the hypertension.