Introduction: Pheochromocytomas are catecholamine-producing tumors derivate from chromaffin cells. Their clinical presentation is variable, with arterial hypertension being the most frequent finding and paroxysms (headache, palpitations, and sweating) the most characteristic. Diagnosis is clinical, through the measurement of serum and/or urinary metanephrines and imaging methods. The great challenge is how to identify these patients. It is estimated that 0.1% of hypertensive patients have pheochromocytomas. The hypertension of these patients can be treated surgically by laparoscopic adrenalectomies. The objective of the study was to evaluate the use of ultrasonography as a screening test for pheochromocytoma in hypertensive patients. Methods: The medical records of all patients who underwent adrenalectomy between 1999 and 2020 were reviewed. Only the patients with a pathologic diagnosis of pheochromocytoma were selected. Results: A total of 29 laparoscopic adrenalectomies were performed in 25 patients, including four bilateral adrenalectomies. The average patient age was 40.2 years old (range 18-66). Ultrasonography was the first exam performed on twenty-nine hypertensive patients in the imaging investigation that showed adrenal masses with a mean diameter of 2.8cm. After that, all patients underwent computed tomography scanning or magnetic resonance imaging, and meta-[131I]iodobenzylguanidine (131I-MIBG) whole-body scintigraphy before adrenalectomy. Measurements of plasma metanephrines and/or urinary catecholamines were high in all patients. Although abdominal ultrasonography usually has low sensitivity and specificity, it was fundamental to identifying patients with adrenal mass and proceeding with the investigation. Conclusions: Ultrasonography was an efficient method for screening investigation of pheochromocytoma in the hypertensive population and is considered a safe, low-cost and fast imaging exam. SOURCE OF Funding: None.
