Pheochromocytoma Before and After Surgery

Abstract

ALTHOUGH many excellent articles ' continue to review the literature of cases of paroxysmal hypertension produced by adrenal medulla tumors, little has been mentioned about the various endocrine manifestations of this condition. This paper, in addition to discussing the pharmacologic and roentgenographic means of diagnosis, will specifically emphasize the various endocrine findings and their significance.Selye 2 first called attention to the effects of stress on the adrenal-pituitary axis. Further work pointed to a specific relationship between epinephrine and this axis. Experimentation with epinephrine administration in animals and later in man resulted in a decrease in the circulating eosinophiles, decrease in adrenal ascorbic acid and cholesterol levels, and an increase in 17-ketosteroid excretion in the urine.3From these findings a test has been devised using subcutaneous injection of epinephrine to ascertain the integrity of this system.3a In cases of pheochromocytoma, in which epinephrine and arterenol (norepinephrine) have been found intermittently or constantly elevated in the blood stream, one is interested in the effects of these agents on the adrenal pituitary axis.