Particularităţi de diagnostic şi tratament chirurgical al bolnavilor cu feocromocitom

Abstract

Background: Our aim is to study the clinical and laboratory features of pheochromocytoma, to develop contemporary diagnostic criteria and to determine the best treatment strategy in patients with pheochromocytoma. Material and methods: The study included 20 pacients that were hospitalized, during the period 2007-2014, in Republican Clinical Hospital with the following diagnosis – pheochromacytoma. The pacients were tested for levels of cathecolamines and their urinary metabolites, ultrasound, CT and MRI were performed. Results: In our group of patients we observed that pheochromocytoma commonly affects the rural population, over 51 years old, with predominant location on the right side. Clinical syndromes encountered in pheochromocytoma such as the cardiovascular, astheno vegetative and metabolic are resulting from nonspecific adrenergic system activity. Pathologies associated with pheochromocytoma do not show any specific features compared to the general population. Specific tests used in the diagnosis are: level of catecholamines and urinary metabolites. CT is the most informative in confirming pheochromocytoma that distinguishes it from other tumors with increased density (20.0 UH) and homogeneous structure. Following the comparative analysis of minimally invasive surgery with the traditional, we concluded that the first one is more advantageous by the duration of hospitalization, decreased use of opioids and fewer postoperative complications. Conclusions: For the diagnosis of pheochromacytoma we use appreciation of urinary catecholamines and their metabolites and imaging tests (ultrasound, CT, MRI). Based on our study and the opinion of many authors, minimally invasive surgery is a preferred method in the treatment of pheochromocytoma.