Pheochromocytoma resistant to alpha-adrenergic blockade.

In a 54-year-old man with a norepinephrine-secreting pheochromocytoma, resistance developed to the alpha-adrenergic blocking agent, phenoxybenzamine hydrochloride. Dosages of 240 mg/day were ineffective. Intravenous phentolamine mesylate reduced his BP at first, but resistance developed to this also. Therapy with alpha-methylparatyrosine, an inhibitor of catecholamine biosynthesis, finally controlled his BP, and the tumor was removed.