Clinical Characteristics and Outcome of Patients With Pheochromocytoma: A Single Center Tertiary Care Experience.

Sara Sohail, Waqas Shafiq, Syed Abbas Raza, Adnan Zahid, Khurram Mir, Umal Azmat
Author Information
  1. Sara Sohail: Endocrinology and Diabetes, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
  2. Waqas Shafiq: Endocrinology and Diabetes, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
  3. Syed Abbas Raza: Endocrinology and Diabetes, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
  4. Adnan Zahid: Endocrinology and Diabetes, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
  5. Khurram Mir: Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
  6. Umal Azmat: Endocrinology and Diabetes, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.

Abstract

Objective The aim of this study was to evaluate the demographic and clinical characteristics of patients with pheochromocytoma and determine the treatment outcome with overall survival rates of patients with pheochromocytoma. Methods A retrospective, cross-sectional study was performed on all the patients with histologically proven pheochromocytoma presenting to Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH & RC) Lahore, between August 2006 and July 2018. Clinical, biochemical and radiological data were collected at presentation, post-surgery, at discharge and till the last follow-up; data was retrieved from hospital records. Cure was defined as no evidence of disease biochemically, clinically, and structurally. Results This study included 29 patients, 69% were female. The three most common symptoms were abdominal pain (51.7%), hypertension (44.8%) and headache (41.4%). Most pheochromocytomas were sporadic (82.8%), all were adrenal gland tumors, and 89.7% were unilateral. All patients underwent adrenalectomy. Open adrenalectomy was performed in 25 patients whereas four underwent laparoscopic adrenalectomy. Fifteen patients experienced postoperative complications. The most frequently documented intraoperative complication was hypotension. Death occurred in two patients, one patient died of metastatic disease secondary to malignant pheochromocytoma and the other patient died from perioperative complications. Cure was documented biochemically and/or radiologically in 96.5% patients. Conclusions Abdominal pain was predominant presenting feature most likely due to large tumor size. Most patients presenting to SKMCH & RC, had large intra-abdominal tumors with high cure rate. Mortality was low despite high rate of perioperative complications.

Keywords

References

  1. Hypertension. 1997 May;29(5):1133-9 [PMID: 9149678]
  2. N Engl J Med. 2002 May 9;346(19):1459-66 [PMID: 12000816]
  3. BJU Int. 2008 Jun;101(12):1561-4 [PMID: 18261156]
  4. Hypertens Res. 2004 Mar;27(3):193-202 [PMID: 15080378]
  5. J Clin Endocrinol Metab. 2004 Feb;89(2):479-91 [PMID: 14764749]
  6. J Hypertens. 1994 May;12(5):609-15 [PMID: 7930562]
  7. J Intern Med. 1995 Oct;238(4):363-7 [PMID: 7595173]
  8. J Clin Endocrinol Metab. 2006 Aug;91(8):2851-8 [PMID: 16735498]
  9. Endocrinol Metab Clin North Am. 2000 Mar;29(1):159-85, x [PMID: 10732270]
  10. Ann Intern Med. 1988 Aug 15;109(4):267-73 [PMID: 3395037]
  11. J Clin Endocrinol Metab. 2014 Jun;99(6):1915-42 [PMID: 24893135]
  12. Lancet. 2005 Aug 20-26;366(9486):665-75 [PMID: 16112304]
  13. N Engl J Med. 1984 Nov 15;311(20):1298-303 [PMID: 6149463]
  14. Acta Med Scand. 1986;220(3):225-32 [PMID: 3776697]
  15. Urology. 2001 Jun;57(6):1025-32 [PMID: 11377298]
  16. Baillieres Clin Endocrinol Metab. 1993 Apr;7(2):491-507 [PMID: 8489488]
  17. JAMA. 2002 Mar 20;287(11):1427-34 [PMID: 11903030]
  18. J Clin Endocrinol Metab. 2001 Nov;86(11):5210-6 [PMID: 11701678]
  19. Anesth Analg. 2000 Nov;91(5):1118-23 [PMID: 11049893]
  20. Arch Intern Med. 1987 Jul;147(7):1289-93 [PMID: 3606286]
  21. World J Surg. 1990 May-Jun;14(3):325-9 [PMID: 1973322]
  22. Am J Surg Pathol. 2002 May;26(5):551-66 [PMID: 11979086]
  23. Pathology. 2009 Feb;41(2):173-7 [PMID: 19152190]
  24. Rev Endocr Metab Disord. 2007 Dec;8(4):309-20 [PMID: 17914676]
  25. S Afr Med J. 2011 Mar 01;101(3):184-8 [PMID: 21382250]
  26. J Intern Med. 2001 Mar;249(3):247-51 [PMID: 11285044]
  27. J Clin Endocrinol Metab. 2001 Apr;86(4):1480-6 [PMID: 11297571]
  28. Am J Surg. 2000 Mar;179(3):212-5 [PMID: 10827323]

Word Cloud

Created with Highcharts 10.0.0patientspheochromocytomastudypresentingadrenalectomycomplicationsperformedCenterSKMCH&RCClinicaldataCurediseasebiochemicallypain7%8%adrenaltumorsunderwentdocumentedpatientdiedperioperativelargehighrateurinaryObjectiveaimevaluatedemographicclinicalcharacteristicsdetermine thetreatmentoutcomeoverallsurvivalratesMethodsretrospectivecross-sectionalhistologicallyprovenShaukatKhanumMemorialCancerHospitalResearchLahoreAugust2006July2018biochemicalradiologicalcollectedpresentationpost-surgerydischargetilllastfollow-upretrievedhospitalrecordsdefinedevidenceclinicallystructurallyResultsincluded2969%femalethreecommonsymptomsabdominal51hypertension44headache414%pheochromocytomassporadic82gland89unilateral AllOpen25whereasfourlaparoscopicFifteenexperiencedpostoperativefrequentlyintraoperativecomplicationhypotensionDeathoccurredtwoonemetastaticsecondarymalignantand/orradiologically965%ConclusionsAbdominalpredominantfeaturelikelyduetumorsizeintra-abdominalcureMortalitylowdespiteCharacteristicsOutcomePatientsPheochromocytoma:SingleTertiaryCareExperiencemedullacatecholaminesplasmametanephrinenormetanephrinelevelsvanillylmandelicacid24-hourvma

Similar Articles

Cited By