AIM: the aim of this retrospective study was to assess our experience in surgical management of bilateral pheochromocytoma (BP) and to report diagnosis methods and therapeutic results of a series of 10 patients treated in "surgical clinique A" department. METHODS: from 1986 to 2005, we studied all cases of histological confirmed BP in their clinical, biochemical and radiological aspects. We analyzed all of therapeutic attitudes suggested and their results. RESULTS: Ten patients underwent adrenalectomy for BP: 6 men and 4 women with age average of 37.1 (13-60). Eight of them were synchronous BP versus two metachronous ones. Eight patients were symptomatic. One of them had a Von Hippel Lindeau syndrome and 2 others had a familial form of BP. For the two asymptomatic cases: the first one was an incidentaloma and the second one was discovered in a MEN IIb screening. As a primary biochemical diagnostic measure, the determination of the excretion rate of cathecholamine in the 24h urine was high among 6 patients. The ultrasonic imaging and CT scanning were done to localize the tumor site. The surgical treatment consisted in a bilateral adrenalectomy in one phase for 5 patients and in two phases for the 5 others (one double laparoscopy). An enucleating of a pancreatic nodule was an associated act practiced on a patient. Perioperative incidents were related in heart rythme dysfunctions, crises of hypertension among 6 patients and a cardiac arrest rehabilitated. In postoperative phase we assess a death case of sepsis chock, an acute adrenal insufficiency, an acute pancreatitis and a liver metastasis one year after the adrenalectomy. All patients were under hydrocortisone (30 mg) for life. CONCLUSION: Bilateral adrenalectomy is the basic treatment of a BP. A familial screening must be systematically carried out. Laparoscopic adrenalectomy has good results.
AIM: the aim of this retrospective study was to assess our experience in surgical management of bilateral pheochromocytoma (BP) and to report diagnosis methods and therapeutic results of a series of 10 patients treated in "surgical clinique A" department. METHODS: from 1986 to 2005, we studied all cases of histological confirmed BP in their clinical, biochemical and radiological aspects. We analyzed all of therapeutic attitudes suggested and their results. RESULTS: Ten patients underwent adrenalectomy for BP: 6 men and 4 women with age average of 37.1 (13-60). Eight of them were synchronous BP versus two metachronous ones. Eight patients were symptomatic. One of them had a Von Hippel Lindeau syndrome and 2 others had a familial form of BP. For the two asymptomatic cases: the first one was an incidentaloma and the second one was discovered in a MEN IIb screening. As a primary biochemical diagnostic measure, the determination of the excretion rate of cathecholamine in the 24h urine was high among 6 patients. The ultrasonic imaging and CT scanning were done to localize the tumor site. The surgical treatment consisted in a bilateral adrenalectomy in one phase for 5 patients and in two phases for the 5 others (one double laparoscopy). An enucleating of a pancreatic nodule was an associated act practiced on a patient. Perioperative incidents were related in heart rythme dysfunctions, crises of hypertension among 6 patients and a cardiac arrest rehabilitated. In postoperative phase we assess a death case of sepsis chock, an acute adrenal insufficiency, an acute pancreatitis and a liver metastasis one year after the adrenalectomy. All patients were under hydrocortisone (30 mg) for life. CONCLUSION: Bilateral adrenalectomy is the basic treatment of a BP. A familial screening must be systematically carried out. Laparoscopic adrenalectomy has good results.