Testing For Pheochromocytoma Research Articles

New Rapid Test for Pheochromocytoma

A new chromatoelectrophoretic urine test based on the quantitative assay of normetanephrine (NM), metanephrine (M), and 3-methoxy-4-hydroxyphenylglycol (G) in a casual urine specimen was used to detect pheochromocytomas. Urine specimens from 40 patients with pheochromocytoma, 50 normotensive subjects, and 25 primary benign hypertensive subjects were analyzed for NM, M, and G using the chromoelectrophoretic test, and the results compared with other tests for pheochromocytoma based on the urinary assay for 3-methoxy-4-hydroxymandelic acid (VMA). Correct results were obtained in all specimens with the chromatoelectrophoretic test as opposed to several equivocal results with the tests that analyze for VMA.

Pitfalls in the diagnosis of pheochromocytoma.

Article1 February 1958PITFALLS IN THE DIAGNOSIS OF PHEOCHROMOCYTOMAGEORGE B. HUTCHISON, M.D., JAMES A. EVANS, M.D., F.A.C.P., DONALD C. DAVIDSON, M.D.GEORGE B. HUTCHISON, M.D.Search for more papers by this author, JAMES A. EVANS, M.D., F.A.C.P.Search for more papers by this author, DONALD C. DAVIDSON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-48-2-300 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe clinical course of patients with tumors secreting epinephrine and norepinephrine is subject to great variations and may often simulate in every aspect the course of patients with essential hypertension. At the present time it is widely recognized that the diagnosis of pheochromocytoma must be considered in the evaluation of every patient with significant hypertension. The importance of establishing the diagnosis is great because of the curability by surgical removal and the possibility of malignant degeneration in the tumor. Two of 12 cases of pheochromocytoma were malignant in our series.2Only 13 verified pheochromocytomas have been found on exploration or...Bibliography1. BartelsCattell ECRB: Pheochromocytoma; its diagnosis and treatment, Ann. Surg. 131: 903-916 (June) 1950. CrossrefMedlineGoogle Scholar2. BartelsDeRisio ECVJ: Malignant pheochromocytoma, Lahey Clin. Bull. 10: 56-62 (Oct.-Dec.) 1956. MedlineGoogle Scholar3. ChapmanSingh WPM: Evaluation of tests used in diagnosis of pheochromocytoma, Mod. Concepts Cardiovas. Dis. 23: 221-228, 1954. MedlineGoogle Scholar4. EmletGrimsonBellOrgain JRKSDMES: Use of piperoxan and Regitine as routine tests in patients with hypertension, J. A. M. A. 146: 1383-1386 (Aug. 11) 1951. CrossrefMedlineGoogle Scholar5. EvansRubitskyBartelsBartels JAHJCCEC: Reëvaluation of reliability of pharmacologic and cold pressor studies in hypertension and pheochromocytoma, Am. J. Med. 11: 448-460 (Oct.) 1951. CrossrefMedlineGoogle Scholar6. GiffordRothKvale RWGMWF: Evaluation of new adrenolytic drugs (Regitine) as test for pheochromocytoma, J. A. M. A. 149: 1628-1634 (Aug. 30) 1952. CrossrefMedlineGoogle Scholar7. GoldenbergAranow MH: Diagnosis of pheochromocytoma by adrenergic blocking action of benzodioxan, J. A. M. A. 143: 1139-1143 (July 29) 1950. CrossrefMedlineGoogle Scholar8. GoldenbergAranowSmithFaber MHAAM: Pheochromocytoma and essential hypertensive vascular disease, Arch. Int. Med. 86: 823-836 (Dec.) 1950. CrossrefGoogle Scholar9. NewtonSmithKolbSmith THGIFODR: Successful use of Regitine (phentolamine) in the diagnosis and surgical management of a case of pheochromocytoma; an appraisal of its clinical usefulness, New England J. Med. 252: 974-979 (June 9) 1955. CrossrefMedlineGoogle Scholar10. Plummer AJ: Personal communication. Google Scholar11. SmithwickGreerRobertsonWilkins RHWECWRW: Pheochromocytoma; discussion of symptoms, signs and procedures of diagnostic value, New England J. Med. 242: 252-257 (Feb. 16) 1950. CrossrefMedlineGoogle Scholar12. Soffer A: Regitine and Benodaine in diagnosis of pheochromocytoma, M. Clin. North America 38: 375-384 (Mar.) 1954. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Presented at the Thirty-eighth Annual Session of The American College of Physicians, Boston, Massachusetts, April 10, 1957.From the Department of Internal Medicine, The Lahey Clinic, Boston, Massachusetts.Requests for reprints should be addressed to James A. Evans, M.D., Lahey Clinic, 605 Commonwealth Avenue, Boston 15, Massachusetts. 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FAWCETT, M.D.Pheochromocytoma diagnosed at cesarean section for labor obstructed by pelvic neurofibromaThe Diagnosis of Pheochromocytoma 1 February 1958Volume 48, Issue 2Page: 300-309KeywordsEpinephrineHypertensionNorepinephrinePheochromocytomaSedation ePublished: 1 December 2008 Issue Published: 1 February 1958 PDF downloadLoading ...

Present-day diagnosis and treatment of pheochromocytoma; a review of fifty-one cases.

• The histories of 50 patients who were found to have pheochromocytomas have been analyzed in order to identify factors that might be important in diagnosis and prognosis. The hypertension characteristic of pheochromocytoma was paroxysmal in 26 and persistent in 24. The tumors are usually benign, but eight in this series were malignant, and seven of the malignant type occurred in the cases of persistent hypertension. Tests for pheochromocytoma should be carried out on patients who complain of spells of severe headache of unexplained cause with perspiration, thoracic and abdominal pain, and nervousness and on any hypertensive patient who is thin and young, who has hypermetabolism without other signs of hyperthyroidism, who give a paradoxical reaction to ganglion-blocking agents, and who responds to anesthetics with a blood pressure rise. The tests consist of the administration of histamine base, tetraethyl-ammonium chloride, phentolamine, or piperoxan and determinations of plasma pressoramines under certain standard conditions. For removal of the tumor a transverse upper abdominal incision is recommended because it gives access to both adrenals and permits the inspection of the abdomen for aberrant masses of adrenal tissue, which are especially likely to occur in the region of the great vessels in the abdomen and about the base of the mesentery of the small intestine. During operation constant attention to the blood pressure is necessary because the pressure often rises sharply when the tumor is handled and falls to dangerously low levels when the tumor is removed. When recurrences or metastases are encountered, it is still possible to prolong the life of the patient by surgery or roentgenotherapy.

Evaluation of new adrenolytic drug (regitine) as test for pheochromocytoma.

The diagnosis of hypertension due to increased amounts of circulating epinephrine, arterenol, or both, released by pheochromocytoma is receiving more and more emphasis for two reasons. 1. It has only recently been recognized that many of these tumors cause sustained elevation of blood pressure, which is clinically indistinguishable from essential hypertension, and not paroxysmal attacks of hypertension. 2. Although pheochromocytomas are a comparatively uncommon cause of hypertension, if a correct diagnosis can be made and surgical removal of the tumor accomplished, the persistent elevation of the blood pressure can be decreased. The differential diagnosis, therefore, between essential hypertension, for which there is only palliative treatment, and that caused by a pheochromocytoma, for which there is surgical relief, is an important one. Although clinical experience and diagnostic acumen may suggest strongly the presence of pheochromocytomas, the introduction of various pharmacologic agents as aids in diagnosis has greatly enhanced the accuracy of

Use of tetraethylammonium bromide as a diagnostic test for pheochromocytoma

Use of tetraethylammonium bromide as a diagnostic test for pheochromocytoma