Endocrine Abstracts

Introduction: Pheochromocytoma (PCC) has a wide spectrum of clinical manifestations, from insidious disease to extreme symptoms. Various mechanisms of catecholamine and other mediators actions were related to the diversity of PCC presentation.

Aim: We describe a retrospective study, of patients with PCC from a tertiary hospital, focusing on clinical and biochemical characteristics of PCC depending on means of discovery.

Material and Methods: Medical files of 67 consecutive patients diagnosed with pheochromocytoma between 1987–2018 were analysed in detail, collecting relevant clinical, hormonal and imaging data. The patients were divided in 2 groups: incidentaloma group (IG) with25 patients incidentally diagnosed with pheochromocytoma, upon imaging performed for reasons unrelated to a blood pressure abnormality or other pheochromocytoma related symptoms;symptomatic group (SG) included 42 patients diagnosed with pheochomocytoma after accusing pheochromocytoma related symptoms: arterial hypertension/hypertension paroxysms, headache, palpitation, sweating, anxiety.

Results: Mean age of diagnosis and tumor dimension were higher in incidentally discovered pheochromocytomas than in clinically suspected PCC (54.8 ± 5.4 vs 44.0 ± 12.2 years old respectively 5.2 ± 2 vs 4.8 ± 2 cm). There were no differences between gender distribution in IG, while in SG, women percentage was higher. As expected, a lower number of patients from IG had chronic hypertension (48%) or hypertension paroxysm (16%), while in SG, more than 90% of the patients reported either chronic hypertension or hypertension paroxysms. Other symptoms related to pheochromocytoma such as headache, palpitations or sweating were more intensive and more frequently reported in SG. Glicemic abnormalities were approximately equal distributed between the two groups. Arterial blood pressure normalization after surgery was reported in more patients from SG than in IG. 25 out of 31 hypertensive patients in SG had normalization of arterial blood pressure postsurgery, while 6 out of 12 hypertensive patients in IG had normal blood pressure after surgery.

Conclusion: Incidentally discovered PCCs are related to a more advanced stage of the disease (reported as higher tumor dimensions in our study) due to delayed time of the diagnosis. Incidentally discovered PCC are often asymptomatic; in half of the cases from our study, patients from IG had essential arterial hypertension rather than secondary hypertension. In case of an incidentaloma it is always required to screen for pheochromocytoma.