The Diagnosis of Pheochromocytoma

Twenty-six cases of pheochromocytoma were seen in a 14-year period (1951-1964) at the Henry Ford Hospital. The presenting complaint often seemed unrelated to the presence of pheochromocytoma. Only 13 patients (50%) gave a history of hypertension, and six were normotensive at the time of initial examination. In 14 of the 18 patients who complained of paroxysmal attacks, the diagnosis was made preoperatively or antemortem. In contrast, the diagnosis was not established clinically in the eight patients failing to report paroxysms. This would seem to point to the importance of ruling out pheochromocytoma in those thought to have primary or socalled essential hypertension. Because of the difficulty of excluding pheochromocytoma by means of clinical examination, it is recommended that ideally either a histamine or phentolamine test be done on every patient with newly diagnosed hypertension.