Clinical and diagnostic aspects of pheochromocytoma in hospitalized patients in Tehran University hospitals

In this study, we aimed at investigating the clinical picture, some biomedical tests, imaging studies and pathological findings, of patients with pheochromocytoma. The case histories of 60 patients with pheochromocytoma were reviewed to determine the clinical history, pathological and anatomical data, biochemical profile that led to the diagnosis of the disease and the method of localization of tumors. Paroxysmal hypertension was present in 98% of our patients and palpitation was present in 43% of our patients. Headache and perspiration were found in 71% and 68% of affected individuals respectively. We found the Vanillylmandelic acid test (biochemical test) and CT scan (imaging technique) to be sensitive tests for the diagnosis and localization of pheochromocytoma. However, MIBG (Meta-iodobenzylguanidine) had lower sensitivity in our series. When determination of VMA (Vanillylmandelic acid) was coupled to 24-hours urine norepinephrine, the diagnosis of pheochromocytoma can be made with high sensitivity. Clinical features seen in the patients in our study differed in some respects from those of some other reviews. Paroxysmal hypertension was much more common and palpitation was much less prevalent than other studies. Determination of VMA coupled to 24-hours urine norepinephrine may present an alternative to the 24-hour urine metanephrine measurement.