Three presented the triple condition of hypertensi- on, pulsatile headache and palpitations. Treatment was surgical in all cases, and the approach was selected based on the tumour's size and location. One patient with severe rheumatic heart disease died on day 3 post-surgery. She had a left adrenalectomy for a pheochromocytoma 7 years earlier. Two small pulmonary nodules were seen on chest X-ray and CT scans.
Pheochromocytomas are functionally active, catecholamine-secreting tumours of chromaffin tissue.
The mainstay of pharmacological therapy is preoperative treatment with oral phenoxybenzamine. Therefore, postoperative hypotension is a hazard of therapy with phenoxybenzamine if adequate plasma volume repletion is not provided. Preoperative therapy with phenoxybenzami- ne was impossible because of the patient's refusal to take the drug. This hypertensive crisis was managed with sodium nitroprusside, nitroglycerin, and esmolol. A multilocular pheochromocytoma was diagnosed.