Endocrine Abstracts

The aim of our study was to estimate the prevalence and describe diagnosis, treatment and follow up strategy of phaeochromocytomas at VUHSC.

Results: There were 702 patients diagnosed with adrenal masses from 2010 to 2014. Only half of patients were screened for phaeochromocytoma which included 24 (the incidence is 3.4%). Phaeochromocytoma was diagnosed in 5 (20.8%) males and 19 (79.2%) females, average age 55±11.5 years. After surgery 2 (8.3%) were confirmed as paragangliomas. Although there were 21 (87.5%) symptomatic patient – most commonly with hypertension – 16 (66.7%), episodic tachycardia – 13 (54.2%), episodic elevations of blood pressure – 12 (50.0%) and sweating – 4 (16.7%), phaeochromocytoma was found incidentally in 15 (62.5%) cases. The average tumour size of 48.0±23.4 mm and density of 33.7±11.6 HV was estimated by computed tomography performed for all patients. Most tumours were found in the left adrenal – 15 (62.5%), bilaterally – in 1 (4.2%) patient. In 45.8% of cases scintigraphy with iodine-123-metaiodobenzylguanidine was performed and uptake confirmed in all suspected tumours. Hormonal activity was confirmed in 20 (83.3%) cases by elevation of plasma metanephrine and/or normetanephrine or urine/plasma adrenaline and/or noradrenaline. Isolated elevations of either adrenaline or metanephrine was detected in 4 (16.7%), noradrenaline or normetanephrine – in 3 (12.5%) cases. Adrenalectomy was performed in 21 (87.5%) patient with suspicion of malignant tumour in 9 (42.9%) of cases after histological examination. Two of them received chemotherapy, but were diagnosed with the recurrence of disease, others are under follow up with no disease relapse. Genetic syndromes were diagnosed in 2 (8.3%) subjects: Von Hippel Lindau syndrome and type 1 neurofibromatosis.

Conclusions: The incidence of phaeochromocytoma in our hospital is 3.4% and meets the rates estimated by others. High prevalence of asymptomatic patients and suspicion of malignant tumours after histology urge for careful assessment of all adrenal masses for phaeochromocytoma.