PRISE EN CHARGE DU PHEOCHROMOCYTOME : EXPERIENCE DU SERVICE DE CHIRURGIE GENERALE DE L’HOPITAL GENERAL IDRISSA POUYE

Abstract

Introduction: Pheochromocytomas (PH) are neuroendocrine tumors developed at the expense of chromaffin cells of the adrenal medulla or sympathetic chain paraganglia. It is a serious condition without the treatment which is essentially surgical. Our goal was to assess the epidemiological, clinical, paraclinical and therapeutic aspects of this pathology through a retrospective study conducted at the General Surgery Department of the Idrissa POUYE General Hospital in Dakar. Patients and method: This was a monocentric retrospective study carried out from January 2005 to December 2022. Included in this study were all patient files presenting an adrenal tumor whose biology or imaging was in favor of a pheochromocytoma. Results: During our study period, 22 cases of pheochromocytomas were treated in the general surgery department of the Idrissa POUYE general hospital. The average age of the patients was 36 years old with extremes of 16 and 66 years old. Sex concerned 86.3% (N; 19) with a sex ratio of 0.2. The average duration of symptom evolution was 10.31 months with extremes of 1 and 36 months. Hypertension associated or not with headaches was found in 81.8% of cases (N: 18). The urinary level of VMA was dosed in 6 patients and returned high in 3 cases (13.66%) The dosage of urinary metanephrines concerned 9 patients and it returned high in 88.8% of cases (N : 8). The plasma metanephrine level was very high in the 6 cases (27.3%) where it was measured. The blood sugar level was high in 2 cases. Abdominal ultrasound in 12 (54.5%) of our patients was in favor of a pheochromocytoma, while CT confirmed the diagnosis in 95.5% of our patients (N: 21). The location of the pheochromocytoma was right in 72.7%. (N: 16). All patients underwent adrenalectomy under general anesthesia. The duration of the hospital stay was 10.6 days on average, the mortality concerned two cases. One year postoperative follow-up was unremarkable. Histology was in favor of benign pheochromocytoma in 90.9%. Conclusion: At the end of our study, we can conclude that pheochromocytomas are rare tumors in young female subjects, generally benign. Surgical treatment accompanied by good resuscitation gives satisfactory results.