Laparoscopic resection of unsuspected pheochromocytoma.

TL;DR: The low risk of adrenalectomy especially via the laparoscopic approach can provide an early definitive diagnosis and treatment, avoiding the cost of repeated CT scans and other studies as suggested by the currently prevailing conservative management of these tumors.

Abstract: P heochromocytoma, a rare catecholamine-secreting tumor, is found in approximately 0.1 % of hypertensive patients and is responsible for the death of about 1000 Americans each year (1). Encounters with pheochromocytoma may occur when anesthetizing suspected cases for invasive radiologic procedures, proven cases for surgical removal, or, most dangerous of all, when anesthetizing unsuspected cases (24 ) . Twenty-five to fifty percent of hospital deaths of patients with pheochromocytoma occur during induction of anesthesia or during operative procedures for other disorders (5). However, the association of pheochromocytoma with hyperthyroidism has not been reported. We describe an unsuspected case of pheochromocytoma which led to a dangerous medical situation under general anesthesia due to an erroneous diagnosis of a thyroid crisis.

TL;DR: The effectiveness of the preoperative preparation of fourteen patients who required surgical excision of a phaeo-chromocytoma was examined in the light of their operative stability, suggesting that patients with phaeochromocytomas with high production of catecholamines are more likely to show cardiovascular instability.

TL;DR: Laroscopic adrenalectomy for pheochromocytomas is difficult because tumors are larger and more complications are seen related to their hormonal secretions, in spite of adequate pharmacologic blockade, however, metastatic extensions can be diagnosed and laparoscopic ablation can be performed in most instances without recurrence.