[Pheochromocytoma: clinical review of 21 cases]

To review the series of patients with pheochromocytoma diagnosed in this institution from 1976 to 1990.

The main clinical features and presentation of 21 patients (13 women and 8 males) with mean age 40 +/- 13 years were reviewed. Urinary excretion of vanillylmandelic acid (VMA) and total catecholamines had been measured. Abdominal echography, computed tomography (CT), adrenal scintigraphy and magnetic resonance (MR) had been used as localizing techniques.

The main clinical feature was hypertension (86%), which was paroxysmal in 57% of patients. 9% were totally asymptomatic at the time of diagnosis. The following diseases were associated: thyroid medullary carcinoma (TMC) in one case, diabetes mellitus (5), cholelithiasis (3), contralateral nonfunctioning adrenal adenoma (2), and renal artery stenosis (1). The values of urinary catecholamines were high in all cases, while that of VMA was falsely negative in 33%. Echography localized the tumor in 10 of the 13 cases where it was carried out, and so did CT in 15 out of 15, scintigraphy in 6 out of 9 and MR in 5 out of 5.

Hypertension, either paroxysmal or not, and increased perspiration were the most remarkable clinical features. VMA measurement has a small diagnostic value. Among the localizing techniques that were used, CT and MR had the highest yield.