Pheochromocytomas are exceedingly dangerous, but uncommon, tumors that synthesize and release epinephrine and/or norepinephrine. In our continuing efforts to improve diagnostic accuracy and to develop better means of treating these patients, we have used out biochemical approach to diagnose correctly a patient who was injecting herself with epinephrine to produce the signs and symptoms of a pheochromocytoma. We showed that the preoperative preparation of patients with pheochromocytoma with the catecholamine synthesis inhibitor, metyrosine, plus Dibenzyline, resulted in better blood pressure control, less blood loss and the need for less intraoperative fluid replacement than the traditional method using Dibenzyline alone. We demonstrated that severe myocardial depression after massive catecholamine release is reversible within 6 to 10 days. Thus, heroic measures are warranted to support these patients until their stunned myocardium can recover.
