[Subclinical Pheochromocytoma: The Surgeons Point fo View - A Single-Institution Experience]

Pheochromocytoma is a rare neuroendocrine tumor. Most of the autopsy studies indicate that large numbers of these tumors remain undiagnosed during life. The most obvious explanation for this fact is its rather non-specific clinical presentation or the absence of any symptoms - the presence of subclinical pheochromocytoma. We report our institution experience with silent pehochromocytomas - their preoperative characteristics, intraoperative management and postoperative complications.

A total of 104 patients underwent operation for pheochromocytoma between 19780 and 2010 in our department. Eleven of them had no clinical symptoms. We describe and analyze retrospectively: indication for diagnosis and surgery, length of hospital stay, intra and postoperative complications.

In total, 11 of the 104 patent operated in our department had no clinical symptoms. From the classical triad (headache, palpitation and diaphoresis) only five of those patients had occasional palpitation when they felt severe anger, which is rather unspecific. When we analyzed the data of these patients we found a longer operative time (p = 0.04), more intraoperative complication (p = 0.02) - higher estimated blood loss and larger transfusion requirement. Postoperative complications however showed no statistical significance.

Pheochromocytoma can have variable presentation. Patients with small incidentalomas schedules for surgery should be closely evaluated and medically treated preoperatively to ensure an excellent outcome.