DIAGNOSIS AND PREOPERATIVE MANAGEMENT OF THE PATIENTS WITH PHEOCHROMOCYTOMA
褐色細胞腫患者の診断および術前管理について

Hitoshi Takeshima, Hiroshi Tomomasa, Shinichi Yoshii, Tohru Shimazui, Fukuji Kondoh, Hiromichi Ishikawa, Kenkichi Koiso
1987 The Japanese Journal of Urology  
Clinical analyses were made on diagnosis and preoperative management of 7 patients with pheochromocytoma (male 2, female 5) in the last 6 years. Chief complaints were palpitation in 3 patients, hypertension, edema in the extremities and headache each in 1 patient. One patient was found to have pheochromocytoma during close examination of another disease. ECG showed abnormal findings in 6 of the 7 patients. Ophthalmoscopic examination showed abnormal findings in all patients. Diabetes mellitus
more » ... s found in 2 patients. Endocrinological studies revealed abnormal levels of noradrenaline and VMA in urine in all patients. Computed tomography, ultrasonography and 1311-MIBG (meta-iodobenzyl guanidine) scintigraphy were reliable procedures for the accurate determination of localization of pheochromocytomas. Reductions of both circulating blood volume and circulating plasma volume were found in 3 patients. Four of the 7 patients were hypertensive before treatments. It was established that quinazoline derivatives, which replaced pheoxybenzamine as alpha-adrenergic recepter blocking agent, were quite useful. Preoperative evaluation of haemodynamics with Swan-Ganz catheter monitoring revealed no serious abnormal findings in 5 patients. This procedure also seemed to be indispensable for intra-and postoperative management of patients with pheochromocytoma.
doi:10.5980/jpnjurol1928.78.1_117 fatcat:loxsuoocnffm5errel4bsl6lnm