Background: The diagnosis of phaeochromocytoma can be difficult and previou
s autopsy studies have found that many of these tumours are not recognised
during life.
Aim: To determine the incidence of phaeochromocytoma during coronial autops
ies and the characteristics of the individuals concerned.
Method: Review of coronial autopsy records from Auckland (1981-97), Melbour
ne (1991-97) and Sydney (1991-97).
Results: Twenty-two patients were found giving an incidence of 0.05% (one t
umour per 2031 autopsies) with similar figures in each centre. Thirteen of
the patients were men, 12 were overweight (body mass index >25 kg/m(2)) and
three of the seven Auckland patients were Maori. Fourteen of the tumours w
ere left-sided, one was extra-adrenal and none had metastasised. The one pa
tient with bilateral tumours had multiple endocrine neoplasia syndrome type
2 (MEN-2) which had not been recognised during life. The heart weight was
increased in 95% of the patients. The tumour may have contributed to the pa
tient's death in up to 50% of the cases, although the true significance of
these lesions as a cause of death remains unclear. Three patients died soon
after general anaesthetics had been given for unrelated reasons.
Conclusions: Even though phaeochromocytomas are uncommon, we fail to diagno
se a significant number of these tumours during life. Methods are needed to
increase the detection of phaeochromocytoma and to distinguish functional
and non-functional tumours.