Endocrine Abstracts (2007) 13 P201

Pheochromocytoma- an experience from a south indian referral center

Nihal Thomas, Mandalam Seshadri, Thomas Paul, Aravindan Nair, Paul Mj, Simon Rajarathinam, Suresh Prabu & Regi Oommen

Christian Medical College, Vellore, Tamil Nadu, India.

Background: Pheochromocytomas are tumors arising from chromaffin cells diagnosed in <1% of patient evaluated for hypertension.

Methodology: A retrospective analysis of case records of those patients with histopathologically confirmed pheochromocytoma in our hospital from 1993–2006 (14 years) was conducted.

Result: A total of 94 patients were diagnosed to have pheochromocytoma during this period. The median age at presentation was 35 years (range 11–71) with an equal sex distribution. Eighty percent were hypertensive at the time of diagnosis. Headache (64%), palpitations (64%) and sweating (60%) were the most common presenting complaints. Hypertensive changes were seen in ophthalmoscopic examination in 87% of patients. In ECG, QTc prolongation was seen in 26%, left ventricular hypertrophy in 30% and of patients. Diabetes mellitus or IGT was seen in 35% of patients. Elevated urinary VMA (24 hrs) was seen in 93% of patients.

MIBG was positive in 85% of patients. Malignant pheochromocytoma which was diagnosed by tumour invasion or metastasis was seen 14% of patients. Extra adrenal pheochromocytoma was seen 16%, followed by bilateral pheochromocytoma in 11% of patients. Hereditary pheochromocytoma seen in 13% of patients which include 5 with Von Hippel Lindau and 6 with Multiple Endocrine Neoplasia.

A median follow-up was 7months (range 1–120) in which persistent hypertension was seen in 16% of patients. Cholelithiasis was seen in 7% of patients.

Conclusion: In our case series the mean age (34 years) of presentation seems to be younger compared to other case series. Twenty percent of our patients were asymptomatic at the time of presentation. Extra adrenal pheochromocytoma was common in our patients (16%). MIBG was falsely negative in 15% of those patients with pheochromocytoma.

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