Sporadic pheochromocytoma is a rare tumor of childhood and accounts for less 
than 1% of cases of hypertension. We describe the presentation and outcome of 19 
adolescents with sporadic pheochromocytoma seen over past 10 years at a tertiary 
care center in north India. The mean age (+/- SD) at presentation was 15.1 +/- 
2.4 years with range from 9-18 years. The male to female ratio was 12:7. The lag 
time between onset of symptoms to diagnosis ranged from 1 month to 5 years with 
mean (+/- SD) of 1.09 +/- 1.02 years. The majority of children presented with 
hypertension and paroxysms. Paroxysms, characterized by the triad of headache, 
palpitations and sweating, was present in 13 (68%) of these patients. Twelve 
(63%) patients had postural fall in blood pressure, ten (53%) had abdominal 
pain, four (21%) had visual blurring, and three (16%) each had palpable 
abdominal mass and significant weight loss at presentation. Nausea and vomiting 
are common symptoms in children with pheochromocytoma and were present in six 
(32%) and three (16%) patients, respectively. Café-au-lait macule was present in 
only two (11%) patients. Urinary vanilyl mandelic acid (VMA) was found to be 
significantly high in ten (53%) patients, and urinary epinephrine and 
norepinephrine in eight (42%). Six (32%) patients had both VMA and urinary 
epinephrine and norepinephrine within normal limits and five (26%) had 
significant elevation of both. The tumor was localized by ultrasonography in 17 
(89%) patients and by computed tomography in 18 (95%), and in one patient it was 
localized by 131I-MIBG scan. Sixteen (84%) patients had adrenal pheochromocytoma 
(including four with bilateral masses), while the remaining three (16%) had 
abdominal extra-adrenal pheochromocytoma originating from sympathetic ganglions. 
The mean (+/- SD) diameter of the tumor was 4.4 +/- 1.7 cm, ranging from 2.2-7.5 
cm. Pre-operatively, hypertension was managed by phenoxybenzamine in six (32%), 
sustained release prazosin in 12 (63%), beta-blockers in 14 (74%), calcium 
channel blockers in 12 (63%), and angiotensin converting enzyme inhibitors and 
diuretics in only two (11%) patients. Eighteen (85%) patients underwent 
exploratory laparotomy for removal of the tumor. On follow-up, 13 (72%) patients 
became normotensive, while six (32%) patients continued to have hypertension. In 
conclusion, childhood pheochromocytoma is characterized by atypical 
symptomatology; ultrasonography is a useful modality in localizing the lesions 
in the majority of patients; surgery is rewarding in most patients.