Endocrine Abstracts

Phaeochromocytoma is a common endocrinological diagnosis with an incidence of 1–2 per 10 000 people. Prompt evaluation and treatment leads to an excellent prognosis. Recurrence has been documented rarely (with literature reporting possibility of up to 8 years delay) and causes are generally attributed to inherited mutations, seeding during surgery or malignancy. Malignancy rates have been variable from 10% depending on site and mutations. In addition, the definition of malignant pheochromocytoma/paraganglioma is not always clear as there is no combination of clinical, histopathologic, or biochemical features to reliably predict biologic behaviour. In general; pathologic evaluations provide little prognostic insight to predict risk of recurrences or metastases reliably. We present a case that demonstrates relapse as a result of possible seeding from original laparoscopic adrenalectomy as one of the factors. Thus, pre-operative features that potentially make the tumour a high risk for recurrence should be identified and aid in creating an individualised management plan. Aspects that have been recognised to be directly related to outcome such as the size of tumour, underlying conditions such as MEN 2A/B and neurofibromatosis, the site of the tumour and anatomical ease of surgical intervention. This case highlights the importance of the recognition of such factors & multidisciplinary team input, to prevent recurrences which have a significant effect on long-term cure and prognosis.