[Pheochromocytomas]

This study of pheochromocytoma addresses only the four aspects which changed dramatically. The diagnosis depends on the clinical picture, biological tests (plasma methoxamine) and the elimination of catecholamines and their metabolites. Abdominal CT scan localizes the tumor. M.I.B.G. scintigraphy is complementary. When the pheochromocytoma is part of a generalized endocrinopathy (MEN II) familial screening is essential. The incidence of malignant tumours is probably higher than the published 10%; these tumors are either of primary malignancy or malignant after a long latency period. Survival, even in primary malignant tumours is considerable. Multiple localizations are detected by M.I.B.G. scintigraphy and determine the treatment strategy. Surgical therapy with a near zero mortality is the factor which most favourably influenced the prognosis. The still high peroperative morbidity, not prevented by adrenolytic therapy, can be counteracted with appropriate pharmacological agents.