Abstract • A 58-year-old man who had a malignant pheochromocytoma with hepatic metastasis was treated with 2 g/mo of Intravenous streptozocin for 18 months. There was a reduction in his urinary excretion of dopamine (from 33,840 to 731 μg/24 hr), homovanillic acid (from 48 to 8 mg/24 hr), and vanillylmandelic acid (from 350 to 74 mg/24 hr). There also was a reduction in the size of his hepatic metastasis (50%) and a right adrenal mass (25%), as well as a marked clinical improvement in his condition. Based on this evidence, I believe further attempts to treat patients with metastatic pheochromocytoma with streptozocin seem warranted. (Arch Intern Med 1983;143:1799-1800) References 1. Drasin H: Treatment of malignant pheochromocytoma. West J Med 1978;128:106-111. 2. Feldman JM, Marecek KE, Quickel KE, et al: Streptozotocin treatment of metastatic carcinoid tumors. South Med J 1973;85:279-294. 3. Weiss RB: Streptozotocin: A review of its pharmacology, efficacy and toxicity. Cancer Treat Rep 1982;66:427-436. 4. Boland RP: The neurocristopathies: A unifying concept of disease arising in neural crest maldevelopment. Hum Pathol 1974;5:409-429.Crossref 5. Hamilton BPM, Cheikh IE, Rivera LE: Attempted treatment of inoperable pheochromocytoma with streptozotocin. Arch Intern Med 1977;137:762-765.Crossref 6. Herrera LO, Hossain SM, Rafal HS, et al: Malignant pheochromocytoma (paraganglioma) of the organ of Zuckerkandl: A study of two cases. J Surg Oncol 1980;14:133-145.Crossref 7. Pisano JJ, Crout JR, Abraham D: Determination of 3-methoxy-4-hydroxymandelic acid in urine. Clin Chim Acta 1962;7:285-290.Crossref 8. Sankoff I, Sourkes TL: Determination by thin-layer chromatography of urinary homovanillic acid in normal and disease states. Can J Biochem 1963;41:1381-1388.Crossref 9. Johnson GA, Kupiecki RM, Baker CA: Single isotope derivative (radioenzymatic) methods in the measurement of catecholamines. Metabolism 1980;29( (suppl 1) ):1106-1113.Crossref 10. Feldman JM, Klatt C: Elevated platelet norepinephrine concentration in patients with pheochromocytomas. Clin Chim Acta 1981;117:279-288.Crossref 11. Anker RM: The determination of creatine and creatinine in urine: a correction factor for the determination of 24-hour urinary excretion values. J Lab Clin Med 1954;43:798-802. 12. Dow CJ, Palmer MK, O'Sullivan JP, et al: Malignant phaeochromocytoma: Report of a case and a critical review. Br J Surg 1982;69:338-340.Crossref 13. Melicow MM: 100 cases of pheochromocytoma (107 tumors) at the Columbia-Presbyterian Medical Center, 1926-1976: A clinicopathologic analysis. Cancer 1977;40:1987-2004.Crossref 14. Scott HW, Reynolds V, Green N, et al: Clinical experience with malignant pheochromocytomas. Surg Gynecol Obstet 1982;154:801-818.
Archives of Internal Medicine – American Medical Association
Published: Sep 1, 1983