Back to Search
Start Over
Emergency resection of an extra-adrenal phaeochromocytoma: wrong or right? A case report and a review of literature.
- Source :
-
The Netherlands journal of medicine [Neth J Med] 2003 Aug; Vol. 61 (8), pp. 258-65. - Publication Year :
- 2003
-
Abstract
- Phaeochromocytomas are rare neuroendocrine tumours that produce symptoms through excess release of catecholamines. Treatment of choice is elective, complete surgical removal after pretreatment with alpha-adrenergic blocking drugs, to prevent dangerous haemodynamic fluctuations. In rare cases a 'catecholamine crisis' develops presenting with pulmonary oedema and circulatory shock. We report such a case of a patient with familial extra-adrenal phaeochromocytoma who successfully underwent emergency surgery. Pathophysiological mechanisms are discussed. Although pretreatment with alpha-adrenergic blocking drugs seems advisable in terms of morbidity and mortality, the concept is based on theory rather than clinical evidence. Surgical management of a catecholamine crisis is associated with high mortality rates. However, proof of better outcome by avoidance or discontinuation of emergency surgery is not available. Based on literature and on this case, we conclude that emergency surgery in phaeochromocytoma does not have to be structurally avoided and may be considered under life-threatening circumstances.
- Subjects :
- Adrenal Gland Neoplasms complications
Adrenal Gland Neoplasms diagnosis
Adult
Emergencies
Female
Humans
Pheochromocytoma complications
Pheochromocytoma diagnosis
Pulmonary Edema etiology
Shock etiology
Tomography, X-Ray Computed
Treatment Outcome
Adrenal Gland Neoplasms surgery
Pheochromocytoma surgery
Surgical Procedures, Operative methods
Subjects
Details
- Language :
- English
- ISSN :
- 0300-2977
- Volume :
- 61
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The Netherlands journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 14628962