Pheochromocytoma: clinical observations from a Brooklyn tertiary hospital.

OBJECTIVE

To report eight cases of pheochromocytoma, diagnosed and treated at our tertiary hospital during a 42-month period.

METHODS

We review clinical manifestations as well as historical and family data. Biochemical and radiologic methods for diagnosis and tumor localization at our institution were compared with methods at other teaching centers.

RESULTS

Among 4,180 patients with essential hypertension encountered during a 42-month interval, 8 had pheochromocytoma. The most common clinical findings were diaphoresis, chest or abdominal pain, palpitations, headaches, and nausea. Clinical features were remarkable only for the significant correlation between urinary excretion of vanillylmandelic acid and tumor volume (r = 0.925; P<0.01). Only one patient, with a history of medullary thyroid carcinoma, had multiple endocrine neoplasia. No unusual familial concentration of pheochromocytomas was found in our community, and our diagnostic techniques were similar to those reported from other institutions. We calculated an average annual incidence rate of 0.5 per 100,000 person-years, a figure comparable to that reported at the Mayo Clinic in Rochester, Minnesota.

CONCLUSION

Because our institution does not see the volume of referral patients as does the Mayo Clinic, we suggest that the frequency of pheochromocytoma may be underestimated in the patient population that we serve.