Pheochromocytoma

PATIENTS with pheochromocytoma pose several challenges of theoretical and practical importance. The problem of the relationship between hyperfunction of chromaffin tissue and hypertension is brought forward in this lesion. Secondly, only hypertension which is caused by a pheochromocytoma can be cured completely by surgical treatment. Finally, the presence of large quantities of circulating epinephrine and arterenol (nor-epinephrine) in the blood of these patients poses serious and difficult problems in anesthetic management. These have a significant bearing on the current high operative mortality rate (approximately 20 per cent). Since pheochromocytoma is an uncommon lesion which has so many facets of interest, a review of the literature was undertaken together with a summary of the experience gained in the operative management of this disease at the Presbyterian Hospital. Criteria for inclusion in this survey were signs and symptoms of hyperadrenalemia and a proved pheochromocytoma at operation or autopsy. Patients without these criteria