Pheochromocytoma in Africa: rarity, gravity, and ectopy.

Pheochromocytoma is one of the main curable etiologies of high blood pressu re, although its diagnosis and therapeutic management can be problematical: an incorrect diagnosis or inappropriate treatment may lead to fatal compli cations. This disease was exceptionally uncommon in the 1950s, and 30 years later about 30 cases had been reported; however, since 1981 there has been a progressive increase in the incidence of pheochromocytoma (48 documented cases in Africa). In Africa, this disease has two particular characteristi cs: the gravity of the clinical symptoms, mainly due to the physiological a nd pharmacological effects of catecholamines which as a result of this dise ase are stored and liberated at very high rates; and the ectopic site in a number of cases. To facilitate the diagnosis of pheochromocytoma improved c linical investigation is therefore advocated, but the necessary medical equ ipment is not always available in Africa. On this continent, the ectopic fa ctor confirms the observations made in the early 1980s, and should be taken into consideration in the diagnosis and management of this disease. (C) 20 01 Editions scientifiques et medicales Elsevier SAS.