Malignant Phæochromocytoma With Functioning Metastases

Davis, Peter; Peart, W. S.; Hoff, W. Van't

doi:10.1016/s0140-6736(55)92694-5

Cited by 62 publications

(20 citation statements)

References 7 publications

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“…For this reason it was thought that the increase in size might be due to an increase in blood flow. This is in accord with an observation on a patient with a phaeochromocytoma during an attack (Davis, Peart & van't Hoff, 1955). Use was then made of the needle to measure the blood flow in the thyroid of one of us (W. S. P.) during a noradrenaline infusion.…”

Section: Mansupporting

confidence: 59%

Effects of noradrenaline and adrenaline on the thyroid

Mowbray¹,

Peart²

1960

The Journal of Physiology

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When Labbe, Tinel & Doumer (1922) first described a patient with a phaeochromocytoma they noticed swelling of the root of the neck in the attacks of sweating, pallor and hypertension. Strombeck & Hedberg (1939) described swelling of the thyroid as at least part of the cause of this increase in neck size.It has been shown that phaeochromocytomata, in different patients, secrete varying proportions of noradrenaline and adrenaline (von Euler, 1951), and Barnett, Blacket, Depoorter, Sanderson & Wilson (1950) have described swelling of the region of the thyroid in two subjects given infusions of noradrenaline. We have carried out a number of experiments in both man and dogs to study this finding further, with particular reference to the changes in blood flow which occur. A preliminary report of these findings has appeared previously (Mowbray & Peart, 1958). METHODSMan Infusions of noradrenaline and adrenaline were given to fifty-one healthy young adults; forty-nine male and two female. All subjects were at rest on normal diet and infusions were given from 30 to 90 min after their midday meal.Infusions containing 4 pg/ml. of either noradrenaline or adrenaline in 0-9 % saline were given into an antecubital vein. The infusions were for periods of 30-90 min, and the infusion rate was adjusted so that the systolic blood pressure for most individuals lay between 170 and 190 mm Hg. The dose of both substances required to maintain this lay between 15 and 30 ug/min.Measurements of blood pressure were made by sphygmomanometer. The measurements of thyroid blood flow were made with a modification of Hensel's heated thermocouple needle (Mowbray, 1959). In this procedure a heated thermocouple is cooled by the tissue blood flow and a reference thermocouple in the same needle compensates for changes in tissue temperature. It was possible to contain the thermocouples and heater in a No. 12 hypodermic needle, which was small enough to be inserted almost painlessly in the thyroid through a small bleb of intradermal procaine solution. Readings of thyroid blood flow were made at 2 min intervals in most subjects, although direct recording of the blood flow has also been used. For this purpose a mirror galvanometer was used for taking spot readings and a DC amplifier with a direct-writing milliammeter for the continuous recordings.

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Section: Mansupporting

confidence: 59%

Effects of noradrenaline and adrenaline on the thyroid

Mowbray¹,

Peart²

1960

The Journal of Physiology

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“…They are rarely malignant and there are no histologic features characteristic of malignancy [2]. The only criteria, which can suggest malignancy, are tumor invasion of adjacent tissue and/or metastasis [3]. The development of metastases usually occurs within l year of treatment and is often heralded by the return of the endocrine manifestations.…”

Section: Discussionmentioning

confidence: 99%

Malignant non-functional paraganglioma of the bladder presenting with azotemia

2007

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Paragangliomas of the urinary bladder are rare tumors representing less than 1% of bladder tumors and are usually benign. Malignant paragangliomas are uncommon and are defined by their clinical behavior rather than the histologic features. We describe a patient with recurrent nonfunctioning paraganglioma of bladder presenting with hematuria and obstructive uropathy due to involvement of ureteroileal anastomoses. Treatment consisted of excision of recurrent lesion involving both lower ureters with the revision of ureteroileal anastomoses. Histology confirmed the presence of nests of tumor cells with abundant eosinophilic cytoplasm. Immunohistochemically the tumor cells were strongly positive for chromogranin A.

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“…11 The only proof of malignancy is distant metastases. 12 Morbidity and mortality are always related to cardiovascular complications such as arrhythmia, myocardial infarction and cerebrovascular accidents or any organ ischaemia due to catecholamine excess and in part due to slow venous blood flow with intravascular clotting resulting in tumour thrombus that poses a significant risk of pulmonary embolism. 3,6 Intracaval extension of pheochromocytoma is likely to be missed during the primary operation, especially if preoperative imaging diagnostic fails to demonstrate the presence and extent of intravenous tumour.…”

Section: Introductionmentioning

confidence: 99%