Preoperative and operative management of patients with phaeochromocytoma.

Ross, E. J.; Prichard, B. N. C.; Kaufman, Léon; Robertson, Archibald; Harries, Bethan

doi:10.1136/bmj.1.5534.191

Cited by 163 publications

(34 citation statements)

References 31 publications

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“…In patients with a phaeochromocytoma the plasma volume and red cell mass may be abnormal (Brunjes, Johns & Crane, 1960;Sjoerdsma, Engelman, Waldman, Cooperman & Hammond, 1966) and a-adrenergic blockade results in antidiuresis (Corcoran, Dustan & Page, 1956) and expansion of plasma volume (Ross, Prichard, Kaufman, Robertson & Harries, 1967). Urinary and plasma electrolyte changes in response to combined a-and /^-adrenergic blockade in patients with phaeochromo¬ cytoma do not appear to have been reported.…”

Section: Introductionmentioning

confidence: 99%

Metabolic Studies in a Patient With a Phaeochromocytoma Associated With Hypokalaemia and Hyperaldosteronism

Wilson¹,

Craig²,

Mills³

1973

Journal of Endocrinology

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A case of phaeochromocytoma with hypokalaemia, hyperaldosteronism, normal cortisol production and normal urinary corticosteroid excretion is described. Both \g=a\-adrenergic blockade and combined \g=a\and \g=b\ blockade resulted in marked antidiuresis with urinary sodium and potassium retention and a rise in plasma volume. Combined \g=a\and \g=b\ blockade led to some reduction in the high aldosterone production rate. The hypokalaemia was corrected by \g=a\-adrenergic blockade. After operative removal of the tumour the aldosterone production rate was normal.The marked reduction in urinary sodium excretion in response to \ g = a \ \ x = r e q -\ adrenergic blockade, if reproducible in other cases of phaeochromocytoma, might be a useful test for the presence of a phaeochromocytoma.

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Section: Introductionmentioning

confidence: 99%

Metabolic Studies in a Patient With a Phaeochromocytoma Associated With Hypokalaemia and Hyperaldosteronism

Wilson¹,

Craig²,

Mills³

1973

Journal of Endocrinology

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“…The preoperative use of the nonselective a-blocker POB was mainly advocated to counteract the sudden release of catecholamines during surgical intervention (Ross et al 1967, Perry & Gould 1972. The dose is increased over a period of 14 days, starting with 10 mg b.d.…”

Section: Managementmentioning

confidence: 99%

Pheochromocytoma: an update on genetics and management

Karagiannis¹,

Mikhailidis²,

Athyros³

et al. 2007

Endocrine Related Cancer

116

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Pheochromocytomas (PHEOs) are rare neoplasms that produce catecholamines and usually arise from the adrenal medulla and are considered to be an adrenal paraganglioma (PGL). Closely related tumors of extraadrenal sympathetic and parasympathetic paraganglia are classified as extraadrenal PGLs. Most PHEOs are sporadic, but a significant percentage (w25%) may be found in patients with germline mutations of genes predisposing to the development of von Hippel-Lindau disease, neurofibromatosis 1, multiple endocrine neoplasia type 1 (MEN1) and 2 (MEN2), and the PGL/PHEOs syndrome, based on the described mutations of the genes for succinate dehydrogenase subunit D (SDHD), B (SDHB), and C (SDHC). As one out of four PHEOs turns out to be a hereditary clinical entity, screening for genetic alterations is important, as it provides useful information for a rational diagnostic approach and management. This review discusses the genetics, the pathophysiology of hypertension, the clinical picture, the biochemical and imaging diagnosis, and the preferred therapeutic approach for PGLs/PHEOs. Furthermore, it emphasizes the need for genetic testing in cases with apparently sporadic PHEOs.

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“…However, there are still indications for choosing an open approach to the adrenal glands, i.e., for technical reasons if a tumor is larger than 8-10 cm or if preoperatively the tumor is suspicious of malignancy. In these cases, the open transabdominal operation remains the most favorable approach [7,12].…”

Section: Discussionmentioning

confidence: 99%