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Endocrine Abstracts (2021) 75 A16 | DOI: 10.1530/endoabs.75.A16

1Hospital Beatriz Âneglo; [email protected]; 2Department of Endocrinology, Hospital Beatriz Ângelo, Loures, Portugal

Background: A pheochromocytoma is a rare neuroendocrine tumor, originating from adrenomedullary chromaffin cells. The pre-surgical management of pheochromocytoma is classically performed with alpha-blockers. However, in some cases other pharmacological approaches can be considered.

Objective: The aim of the study is to describe the clinical course of patients with pheochromocytoma prepared for surgery with calcium channel blockers (CCB).

Methods: We collected clinical data from patients with pheochromocytoma submitted to surgery in our institution who were prepared with CCB, from 2012 to 2020.

Results: In our institution, 5 patients with pheochromocytoma, 3 males and 2 females, were prepared to laparoscopic surgery with CCB. The ages at diagnosis ranged from 43 to 76 years-old. The mean plasmatic normetanephrine was 989 pg/ml (RR<196) and metanephrine 632,4 pg/ml (RR<65). Arterial hypertension was controlled with nifedipine (60-90 mg/day) in four patients and with amlodipine (5 mg/day) in one patient. During the surgery, three patients needed sodium nitroprusside and a short acting beta-blocker during the tumor manipulation, showing recovery. One patient presented arterial hypotension after tumor removal that solved with phenylephrine. No other intercurrences were registered. Three patients were discharged in 2 days, one patient in 4 days, and the longer hospitalization lasted 8 days due to a respiratory infection.

Conclusions: We can consider that patients with pheochromocytoma can be submitted to a successful surgery without preoperative profound and long-lasting alpha adrenergic blockade. According to literature, alpha blockers are associated to orthostatic hypotension, reflex tachycardia and refractory hypotension after tumor removal. Thus, calcium channel blockers might be a safe alternative in pre-surgical management, with less adverse effects, being easy to titrate and without the need of hospitalization before surgery for hemodynamic stabilization.

Volume 75

ESE Young Endocrinologists and Scientists (EYES) Annual Meeting

European Society of Endocrinology 

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