1Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Koarea 2Department of Surgery, College of Medicine, Ajou University, Suwon, Korea
Purpose: Approximately 1.6-30% of histologically proven pheochromocytomas are discovered by radiologic
examination in the absence of symptoms. The aim of this study was to analyze the asymptomatic
pheochromocytoma, to compare with typical pheochromocytoma.
Meterials and Methods: Fifty seven patients were reviewed who diagnosed pheochromocytoma at from 1988 to
2009. In the current study, we evaluated the characteristics of asymptomatic pheochromocytoma(AP) in 12 patients
and compared with other 45 patients with typical pheochromocytoma(TP).
Results: Catecholamine overproduction was observed in 8 (66.7%) of AP patients. In particular, the mean values of
biochemical parameters were lower in AP patients compared to TP patients, and single catecholamine
overproduction was frequently observed. Despite preoperative preparation in forty seven patients, intraoperative
hypertension occurred in thirty eight patients with spiking of >160 mmHg. In the asymptomatic group, there were 6
cases of spiking blood pressure higher then 160 mmHg. Intraoperative hemodynamic changes were not
significantly different between AP and TP. During follow-up, there were five cases of recurrent disease (1 in the
asymptomatic group and 4 in the typical group), and 1 case of recurrent disease was malignant.
Conclusion: Catecholamine screening in all patients with adrenal tumors is essential. Even in asymptomatic
pheochromocytoma patients, there exists a likelihood of catecholamine overproduction, the surgical extirpation
may offer an advantage. Such patients should be appropriately prepared before surgical intervention and regular
and long term follow-up should also be considered to detect recurrent disease.
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