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. 1976 Jul;184(1):26–30. doi: 10.1097/00000658-197607000-00004

Hemorrhagic necrosis of pheochromocytoma associated with phentolamine administration.

C W Van Way 3rd, R P Faraci, H C Cleveland, J F Foster, H W Scott Jr
PMCID: PMC1344300  PMID: 938114

Abstract

A case of ruptured pheochromocytoma is presented, the pathophysiology discussed, and the literature reviewed. Evidence is presented that the use of alpha-adrenergic blockade in general, and phentolamine in particular, may predispose to this complication. Twelve cases of massive hemorrhagic necrosis with or without rupture were found in the literature, including the present case. Six had no operation; one survived. Six had immediate operation; 4 survived. An additional case of hemorrhage into a small pheochromocytoma following phentolamine is presented. This tumor was neither ruptured nor massively necrotic, but the case supports the hypothesis that alpha-adrenergic blockade may cause hemorrhage within the pheochromocytoma.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amador E. Adrenal hemorrhage during anticoagulant therapy. A clinical and pathological study of ten cases. Ann Intern Med. 1965 Oct;63(4):559–571. doi: 10.7326/0003-4819-63-4-559. [DOI] [PubMed] [Google Scholar]
  2. BRODY I. A. Shock after administration of prochlorperazine in patient with pheochromocytoma; report of a case with spontaneous tumor destruction. J Am Med Assoc. 1959 Apr 11;169(15):1749–1752. doi: 10.1001/jama.1959.73000320003013a. [DOI] [PubMed] [Google Scholar]
  3. Delaney J. P., Paritzky A. Z. Necrosis of a pheochromocytoma with shock. N Engl J Med. 1969 Jun 19;280(25):1394–1395. doi: 10.1056/NEJM196906192802508. [DOI] [PubMed] [Google Scholar]
  4. Delaney P. V., Mungall I. P. Bilateral malignant phaeochromocytomas presenting as massive retroperitoneal haemorrage. J Ir Med Assoc. 1971 Sep;64(418):428–429. [PubMed] [Google Scholar]
  5. GILLILAND I. C., DANIEL O. Phaeochromocytoma presenting as an abdominal emergency. Br Med J. 1951 Aug 4;2(4726):275–277. doi: 10.1136/bmj.2.4726.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. HUME D. M. Pheochromocytoma in the adult and in the child. Am J Surg. 1960 Apr;99:458–496. doi: 10.1016/0002-9610(60)90141-0. [DOI] [PubMed] [Google Scholar]
  7. HUSTON J. R., STEWART W. R. HEMORRHAGIC PHEOCHROMOCYTOMA WITH SHOCK AND ABDOMINAL PAIN. Am J Med. 1965 Sep;39:502–504. doi: 10.1016/0002-9343(65)90217-2. [DOI] [PubMed] [Google Scholar]
  8. KOONCE D. H., POLLOCK B. E., GLASSY F. J. Bilateral pheochromocytoma associated with neurofibromatosis; death following aortography. Am Heart J. 1952 Dec;44(6):901–909. doi: 10.1016/0002-8703(52)90138-5. [DOI] [PubMed] [Google Scholar]
  9. LEHMAN D. J., Jr, ROSOF J. Massive hemorrhage into an adrenal pheochromocytoma. N Engl J Med. 1956 Mar 8;254(10):474–476. doi: 10.1056/NEJM195603082541007. [DOI] [PubMed] [Google Scholar]
  10. LOPEZ J. F. Phenochromocytoma of the adrenal gland with granulosa cell tumor and neurofibromatosis: report of a case with fatal outcome following abdominal aortography. Ann Intern Med. 1958 Jan;48(1):187–199. doi: 10.7326/0003-4819-48-1-187. [DOI] [PubMed] [Google Scholar]
  11. LUND-JOHANSEN P. Shock after administration of phenothiazines in patients with pheochromocytoma. Acta Med Scand. 1962 Nov;172:525–529. doi: 10.1111/j.0954-6820.1962.tb07187.x. [DOI] [PubMed] [Google Scholar]
  12. McAlister W. H., Koehler P. R. Hemorrhage into a pheochromocytoma in a patient on anticoagulants. J Can Assoc Radiol. 1967 Sep;18(3):404–406. [PubMed] [Google Scholar]
  13. McDonald F. D., Myers A. R., Pardo R. Adrenal hemorrhage during anticoagulant therapy. JAMA. 1966 Dec 5;198(10):1052–1056. [PubMed] [Google Scholar]
  15. SALTZ N. J., LUTTWAK E. M., SCHWARTZ A., GOLDBERG G. M. Danger of aortography in the localization of pheochromocytoma. Ann Surg. 1956 Jul;144(1):118–123. doi: 10.1097/00000658-195607000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]

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