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2015, Número 3

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Rev Mex Cardiol 2015; 26 (3)


Feocromocitomas: diagnóstico y tratamiento

Sánchez-Turcios RA

Idioma: Ingles.
Referencias bibliográficas: 45
Paginas: 118-124
Archivo PDF: 191.78 Kb.


RESUMEN

Los feocromocitomas son neoplasias que tienen su origen en las células cromafines de la médula adrenal; 80 a 90% están localizados en una de las glándulas adrenales. Es una patología caracterizada por múltiples signos y síntomas que constituyen un cuadro clínico heterogéneo, complejo y con alto índice de morbilidad y mortalidad cardiovascular. La principal secreción son los metabolitos de las catecolaminas: metanefrina y normetanefrina. El diag­nóstico se realiza con la determinación de metanefrinas libres en plasma (no conjugadas) y metanefrinas fraccionadas en orina de 24 horas; la localización es fundamental por diferentes procedimientos de imágenes. El tratamiento preoperatorio inicialmente es con antagonistas a adrenérgicos y agregándose una semana después antagonistas b adrenérgicos. El tratamiento transoperatorio requiere de un grupo de profesionales versados en la materia. El tratamiento transoperatorio es de vital importancia. Su tratamiento actual depende del tamaño y de la existencia o no de metástasis. Se ha preferido laparoscopia adrenal vía retroperitoneal; se utiliza la vía anterior cuando el tumor es › 6 cm; otros han considerado el tamaño de 6 cm a 15 cm. Los paragangleomas son feocromocitomas de los ganglios extra-adrenales.


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