Abstract | BACKGROUND: PATIENTS AND METHODS: RESULTS: Surgery unrelated to the adrenal lesion (n = 3) or biopsy of the adrenal mass (n = 1) was performed without prior endocrine work-up. Pronounced hemodynamic instability including hypertensive crisis was observed during surgery in all patients. In contrast, in the same patients preoperative alpha-blockade with phenoxybenzamine and an increased awareness of the potential risks led to improved hemodynamic stability following adrenalectomy for pheochromocytoma. CONCLUSION: Our series is a strong reminder of the risks associated with surgery in patients harboring an unsuspected pheochromocytoma and underscores the need to exclude a pheochromocytoma in all patients with an adrenal mass and without a definitive diagnosis of the mass, especially when they are scheduled for surgery or adrenal biopsy. Otherwise, life-threatening hypertensive crisis can be precipitated even in the previously asymptomatic patient.
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Authors | Dirk Weismann, Martin Fassnacht, Barbara Schubert, Roland Bonfig, Alexander Tschammler, Stephan Timm, Stephanie Hahner, Christian Wunder, Bruno Allolio |
Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 13
Issue 12
Pg. 1696-701
(Dec 2006)
ISSN: 1068-9265 [Print] United States |
PMID | 17009139
(Publication Type: Case Reports, Journal Article)
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Topics |
- Adrenal Gland Neoplasms
(diagnosis)
- Aged
- Carcinoma, Transitional Cell
(pathology, therapy)
- Colorectal Neoplasms
(pathology, therapy)
- Humans
- Male
- Melanoma
(pathology, therapy)
- Middle Aged
- Neoplasms, Second Primary
(pathology)
- Pheochromocytoma
(diagnosis)
- Prostatic Neoplasms
(pathology, therapy)
- Skin Neoplasms
(pathology, therapy)
- Thyroid Neoplasms
(pathology, therapy)
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