Characteristics and outcome of patients with pheochromocytoma at a tertiary endocrinology clinic in Durban, South Africa over 14 years

Abstract

Objectives: To evaluate the characteristics and outcomes of treatment of patients with pheochromocytoma at Inkosi Albert Luthuli Central Hospital (ILACH) in Durban, South Africa over 14 years. Design: Retrospective chart review. Setting and subjects: Patients with pheochromocytoma attending the endocrinology clinic at IALCH between 2012 and 2016 were studied. Outcome measures: Clinical, biochemical and radiological data were collected at presentation, on discharge, one year and five years after surgical intervention; tumour characteristics, histopathological features and surgical outcome were also assessed. Results: The analysis included 35 patients (mean age 33.2 ± 15.7 years; 60% female). Headache (68.6%), palpitation (60%) and sweating (57.6%) were the three most common presenting symptoms; hypertension was the predominant clinical finding (85.7%). Most pheochromocytomas were sporadic (82.9%), adrenal gland tumours (68.6%) and benign (77.1%); of eight patients with malignant tumours, two were familial. Adrenalectomy was undertaken in the majority (n = 34; 97.1%); 55.2% were large tumours. The use of adjunctive radiotherapy (n = 4; 11.4%) and chemotherapy (n = 1; 2.9%) was low. There was low overall mortality (5.7%), but 57.6% developed intraoperative hypotension. At one year postoperatively, 80% (n = 28) of patients were defined as cure, biochemically in 23 (82.1%) and with radiology in five (17.9%). Conclusions: Most patients presenting to IALCH had large intra-abdominal tumours with high cure rate, low mortality but a high rate of perioperative complications. Late presentation and large tumour size was a feature.