Comparative study of nine patients with adrenal pheochromocytoma and eleven patients with extraadrenal pheochromocytoma

Twenty patients with the diagnosis of pheochromocytoma were studied from Ja nuary 1990 to January 1998. Nineteen patients had a pathologic investigatio n performed. The mean age of patients was 49 +/- 16 years (range: 24-71 yea rs), 8 males and 12 females. Nine cases corresponded to adrenal and eleven to extra-adrenal (paragangliomas) pheochromocytomas. The anatomic location was similar in both adrenal glands and for paragangliomas the cervical loca tion predominated. The most consistent clinical finding in our patients was maintained arterial hypertension, followed by headache, palpitations and f lushing. Biochemically, an increase in urine catecholamine levels or their metabolites was found in 82.2%. The clonidine test was very useful, particu larly for cases where biochemical results were discrepant. CT, NMR and gamm agraphy with I-123-MIBG have a high sensitivity for locating pheochromocyto mas. NMR and gammagraphy with In-111-pentreteotide located cases in which C T or I-123-MIBG were negative. Preoperative treatment with adrenergic alpha -blockers allowed to surgery with no arterial tension complications. Only o ne patient with multiple abdominal paragangliomas relapsed. No differences regarding clinical manifestations, biochemical parameters or imaging studie s were found between pheochromocytomas and paragangliomas, except their loc ation.