Challenges in Management of Pheochromocytoma at a Tertiary hospital in Northern Tanzania. A 21 Years Descriptive Retrospective Study.

Background: Pheochromocytomas are rare catecholamine-secreting tumors that arise from chromaffin tissue within the adrenal medulla and extra adrenal sites (paraganglioma). Due to excess secretion of catecholamines, these tumors often cause debilitating symptoms ending to death if actions are not taken. Management requires competent physician, surgeons and anesthesiologists. The main objective the study focused on pattern of presentation and treatment challenges of pheochromocytoma patients over a period of 21 years (1992- 2012)
Methods: This was a retrospective study on patients underwent adrenelectomy at KCMC Urology Institute during the course of 21 years and histologically confirmed cases of pheochromocytoma were enrolled. A structured data collection sheet was designed with parameters of demographic data, disease presentation, investigations done, tumor localization, surgical technique and follow up, in a course of overseeing the challenges in each step of management.
Results: A total of 13 patients were included in this study, median age of participants was 25 years. M:F 6:7. Majority of patients presented with clinical features related to episodic elevation of catecholamines. Localization of the tumor was done with ultrasonography, Computer Tomography scan and upon surgical exploration.12 cases were found to have right side tumor and 1 case was on the left. All cases were operated using the Chevron incision as the main surgical approach.12 patients got symptoms cured at the first 3 month visit. One died in the ward.
Conclusion: Upon a study Pheochromocytoma showed to be a rare condition. Despite the challenges occurred in managing all the cases, surgery has cured in 99% of all patients operated. Radiological investigation was able to localize the tumor in 100% of the patients.