[Adrenal pheochromocytoma. Current aspects of diagnosis and treatment]

Since 1984, 5 patients with pheochromocytoma were operated in our department. Diagnosis was suspected by clinical findings and symptoms, and confirmed by measuring catecholamines and metabolites in 24 hours urine specimen. CT Scan located all the tumors. Iodine 131-MIBG confirmed the diagnosis and the location since it was used for the last three cases. Patients were prepared with alpha-blockade with or without beta-blockade. Volume expansion and monitoring with Swan-Ganz catheter was performed 24 hours before the operation. The surgical approaches were: anterior trans-abdominal once, thoraco-abdominal twice, and retro-peritoneal twice with less morbidity. We propose the following attitude when pheochromocytoma is suspected: 1. 24 hours urine catecholamines and metabolites, 2. CT-Scan and RMN if available, 3. Iodine 131-MIBG scintigraphy, 4. Pre-operative alpha-blockade associated with beta-blockade if necessary, 5. Retro-peritoneal approach for the uni-lateral adrenal pheochromocytoma.