Pheochromocytoma--a report of 12 cases.

In a series of 12 cases of pheochromocytoma, 11 patients were clinically cured by operation and one died of malignant tumor. It has been reported that of patients presenting with hypertension, 0.5 to possibly 2 per cent will be found to have pheochromocytoma. This small group of patients will have a good chance of cure of hypertension by surgical removal of the tumor. Hypertension and manifestations of hypermetabolism are classically seen in pheochromocytoma, but these symptoms vary, and hypertension may be entirely absent. Hypertension which is no longer dependent on pressor amines may result after prolonged circulation of pressor substances in the bloodstream. The quantity and proportion of the pressor amines in the circulation are largely responsible for the variable clinical picture. The Regitine(R) test is an excellent screening test but is not absolutely specific for pheochromocytoma. The histamine test should not be employed in patients whose blood pressure exceeds 160/110 mm. of mercury, lest it set off cerebrovascular accident.A modification of the Garlock transdiaphragmatic incision that was used in the present series of cases affords unparalleled exposure and facility in the removal of pheochromocytoma.