ECE2016 Eposter Presentations Endocrine tumours and neoplasia (68 abstracts)
Silent incidental adrenal pheochromocytoma
Asma Bettaibi 1 , Manel Jemel 1 , Kamel Ktari 2 , Hela Marmouch 1 , Hanen Sayedi 1 , Sameh Graja 1 , Hammadi Saad 2 & Ines Khochtali 1
1Department of Endocrinology and Internal Medicine in Fattouma Bourguiba University Hospital, Monastir, Tunisia; 2Department of Urologic Surgery in Fattouma Bourguiba University Hospital, Monastir, Tunisia.
Introduction: The widespread use of abdominal ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) has led to a predictable rise in the discovery of incidental adrenal lesions, some of which will be silent pheochromocytoma. Thus, about ten en percent of pheochromocytoma cases were diagnosed incidentally.
Methods: We studied retrospectively the notes of 23 patients with histologically confirmed pheochromocytom. Demographic information, pre-existing medical conditions, and the presence of classic pheochromocytoma symptoms (headache, sweating, palpitations, febrile sense, or episodic hypertension) were recorded. The aim of our study was to investigate the clinical characteristics and functional status of those who were asymptomatic.
Results: We recorded seven patients with silent pheochromocytoma (30% of confirmed pheochromocytoma). Mean patient age at presentation was 39±11 years. The seven patients had unilateral enlargement on the left side. The Average maximum tumor diameter, as detected by CT was 4.2±0.9 cm. Mean Washout on delayed enhanced CT was 64±14%. All the adrenal masses were heterogeneous and necrotic in 4 cases. The urine fractionated metanephrine measurements were elevated at least 2 to 4 times above normal levels in 5 cases.
Conclusion: Every incidentally discovered adrenal mass should be investigated for pheochromocytoma even in the lack of symptoms. The literature indicates that incidental pheochromocytoma cases that are smaller than 1 cm have no clinical symptoms. Rarely, some large pheochromocytoma cases do not show any clinical symptoms but in our study the size of the adrenal masses is greater. Sublaboratory pheochromocytoma are rare. CT can show features of suspicious morphology (calcifications, necrotic or cystic changes, and inhomogeneity) used as a screening tool for pheochromocytoma.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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