Evaluation of Pharmacologic Tests as an Aid in Diagnosis of Pheochromocytoma: With Report of a Case of Pheochromocytoma and Tuberculosis

¹ Section of Physiology, Mayo Clinic and Mayo Foundation.
² Section of Medicine, Mayo Clinic and Mayo Foundation.

1. It is not likely that many patients with tuberculosis will have pheochromocytomas in the adrenal gland; however, since pharmacologic tests for pheochromocytoma can be carried out easily, it might be advisable to use them on any patient who has tuberculosis and severe headaches, as in the patient reported on in this paper.

2. Although intrathoracic pheochromocytomas are rare, physicians and surgeons interested in thoracic diseases should be aware of the hazards of such tumors and the desirability of correct diagnosis before operation.

3. Pharmacologic tests with histamine or regitine for pheochromocytoma can be done quickly and without hazard if proper precautions are taken, particularly the avoidance of premedication. No untoward reactions or fatalities have occurred with any of these tests at the Mayo Clinic.

4. The preoperative diagnosis of pheochromocytoma can be made with the aid of these tests and their use will prevent fatalities or reactions due to the unexpected finding of a pheochromocytoma during removal of a paravertebral tumor from the thorax.

5. Although removal of the pheochromocytoma in the patient herein described, whose pulmonary condition was active and extensive, did not affect his pulmonary tuberculosis, his general condition was improved. Relief of the headaches was obtained and he gained 10 pounds in the next 7 weeks. He lived comfortably for 2 more years.