Endocrine Abstracts

In pheochromocytoma, intense lypolitic activity may lead to altered lipid profile, which can reverse after tumour removal.

Aim: In this study, we evaluated before and at 3 months after surgery for a cathecholamine secreting tumour, a group of 19 patients diagnosed with pheochromocytoma (17) or paraganglioma (2).

Patients and methods: 13 women and 6 men, aged 53.68±12.75 years (36–75), presented with a clinical picture of paroxistic high blood pressure and decrease of body weight, associated with other signs suggesting excess of cathecholamines in 16/19, three cases being oligosymptomatic. The initial evaluation confirmed excess of plasma metanephrines (736.11±886.51 pg/ml), normetanephrines (2423.26±1907.6 pg/ml) and chromogranin A (790.44±697.85 ng/ml).

Results: Lipid profile was evaluated by total plasma cholesterol (220.27±50.39) and triglycerides (135.11±74.84 mg/dl), being abnormal for total cholesterol in 11/19 cases. A CT scan detailed the tumour, with tumour diameters of 68±20 mm (110–40 mm), the local invasion and allowed surgical approach. The patients were prepared for surgery using alpha (phenoxybenzamine) and alpha-beta (carvedilol) blockade for 2–3 weeks. Surgery was uneventful in all cases. After surgery, all cases showed a normalisation of catecholamine levels, for plasma metanephrines (21.32±18.41 pg/ml), P=0.001, normetanephrines (67.79±48.82 pg/ml) P<0.001 and chromogranin A (95.83±81.28 ng/ml), P<0.001. The lipid profile showed an improvement in cholesterol levels after surgery (187.82±44.14), P=0.01, in nine cases being improved but in two worsened. In addition, three of the cases with normal preoperative values presented an increased cholesterol post surgery. Triglyceride levels decreased but did not reach statistical significance (109.5±41.02 P=NS). Tumour diameter was strongly correlated with metanephrine and normetanephrine (P<0.001) values.

Conclusion: In pheochromocytoma, tumour removal improves also the hypercholesterolemia. Definitive metabolic treatment should be decided at 3 months after surgery.