Computerized tomography guided percutaneous ethanol injection for the treatment of hyperfunctioning pheochromocytoma.

Abstract

PURPOSE: We validated the therapeutic efficacy of computerized tomography (CT) guided percutaneous ethanol injection (PEI) for hyperfunctioning pheochromocytoma. MATERIALS AND METHODS: Pheochromocytoma was treated with CT guided PEI in 41 patients, including 19 men and 22 women with a mean age of 42 years (range 31 to 59). Of the 41 patients 40 had a solitary adrenal benign pheochromocytoma (18 on the left and 22 on the right side), which was diagnosed by biopsy in 36 and by typical clinical manifestations, laboratory and CT findings in 4. The remaining patient with malignant pheochromocytoma, who underwent surgical resection 2 years ago, had 2 recurrent lesions along the right sympathetic chain. RESULTS: CT or magnetic resonance imaging followup 7 to 20 days after treatment showed that adrenal benign pheochromocytoma disappeared in 27 patients and became completely necrotic or shrank in 13. The 2 malignant recurrent lesions also disappeared completely. During the followup of 23 to 54 months the foci disappeared completely in 31 patients, and shrank and completely necrotized in 10. All patients showed normal blood pressure without intermittent vertigo, complexion pallor or numbness of the 4 extremities. Blood and urine catecholamine was also within the normal range. CONCLUSIONS: The therapeutic efficacy of CT guided PEI for hyperfunctioning pheochromocytoma is definite and worth widespread application because the procedure is safe, microtraumatic and less costly, and has low morbidity.