Pheocromocytoma is a rare neuroendocrine tumour arising from chromaffin cells with a variety of clinical symptoms and extremely challenging to diagnose. Aim of this study is to analyse different presentations of Pheochromocytoma in a tertiary care in Sri Lanka
This is a retrospective descriptive study done on patients with Pheocromocytoma followed up at the Endocrine clinic at the National Hospital of Sri Lanka from 2022-2024.
A total of fifteen cases were analyzed with a mean age of 38.2 ± 11.45 years. Majority were females (60%) 7 patients had young onset hypertension where one had resistant hypertension during pregnancy. One patient had worsening hypertension and two were diagnosed accidentally. One patient was diagnosed while screening for MEN 2 and one had Neurofibromatosis 1 with a stroke. One patient had Adrenal incidentaloma.6 patients had classic triad of symptoms. Other symptoms included abdominal pain, loss of appetite, loss of weight and hyperglycemia. All the patients had hypertension. One patient who had recurrence twice along with retinal hemangioblastoma and bilateral renal cell carcinoma, developed addisonian crisis due to poor compliance. Two patients were diagnosed with malignant pheochromocytoma and one of them developed liver metastasis post adrenalectomy. Mean 24 hour unrinary metanephrine level was 8.8 ± 11.5 mg/24 hours. Majorty of the patients had unilateral adrenal lesion ranging from 4.5×4.8×3.7cm to 9 ×9× 14cm except the one with MEN2 who had bilateral lesions. One patient had composite pheochromocytoma with ganglioneuroma. 8 patents underwent laparoscopic adrenalectomy among which, one underwent open adrenalectomy following recurrence. Patient with the bilateral lesion underwent bilateral laparoscopic adrenalectomy. PASS score was above 6 in 4 patients. All patients had symptomatic and biochemical recovery after surgery.
Considering the variety of clinical features threshold to diagnose Pheochromocytoma should be lower. Timely diagnosis and management resulted positive outcome in most of the patients.