Phaeochromocytoma in Nepal--a single centre experience

Area of Science:

• Endocrinology
• Surgical Oncology
• Nephrology

Background:

• Phaeochromocytomas are rare neuroendocrine tumors arising from chromaffin cells.
• Classic symptoms include palpitations, headache, and sweating due to catecholamine excess.
• Diagnosis involves biochemical tests (catecholamines/metabolites) and imaging (CT, MRI, MIBG).

Purpose of the Study:

• To investigate the clinical spectrum and management strategies for phaeochromocytomas.
• Focus on cases treated at Tribhuvan University Teaching Hospital, Nepal.
• Evaluate diagnostic and perioperative care for phaeochromocytoma patients.

Main Methods:

• Retrospective case record review of 12 histologically confirmed phaeochromocytomas (2008-2011).
• Data collected on clinical presentation, diagnostic methods, surgical management, and patient follow-up.
• Analysis of perioperative blood pressure control and outcomes.

Main Results:

• Twelve patients underwent surgery for phaeochromocytomas, with a mean age of 36.4 years.
• Atypical presentations included psychiatric manifestations and blurred vision.
• Diagnosis utilized urinary Vanillyl Mandelic Acid (VMA) and CT scans; all underwent open surgery.
• Preoperative prazocin or calcium channel blockers managed blood pressure; 10/12 had intraoperative surges.
• No major morbidity or mortality; postoperative hypertension was managed with antihypertensives.

Conclusions:

• Phaeochromocytomas exhibit diverse clinical presentations, including atypical symptoms.
• Thorough preoperative optimization and meticulous perioperative care are key to successful phaeochromocytoma management.
• Excellent outcomes are achievable with appropriate patient preparation and surgical management.