Endocrine Abstracts

Introduction/objective: Pheochromocytomas are increasingly diagnosed in incidentally detected adrenal masses, with the advent of modern imaging modalities and increased access to imaging. The proportion of pheochromocytomas in adrenal incidentalomas is relatively low, ranging from 7% to 25% of cases recently. Given the evolution of the presentation of pheochromocytomas, we sought to evaluate the proportion and clinical, biochemical and radiological characteristics of incidental pheochromocytomas and compare them to pheochromocytomas whose mode of discovery was adrenergic symptoms and/or uncontrolled hypertension.

Patients and methods: A retrospective descriptive and analytical study including 48 patients hospitalized for pheochromocytoma in the endocrinology-diabetology department of the public hospital (EPH) Bologhine Ibn Ziri - Algiers, Algeria, spread over a period of 20 years.

Results: After excluding pheochromocytomas diagnosed via screening of genetically predisposed individuals (n=7; 14.6%), we individualized two groups: group 1, pheochromocytoma diagnosed in a context of adrenal incidentaloma (63.4% of patients) and group 2, pheochromocytoma diagnosed by adrenergic symptoms and/or uncontrolled hypertension (36.6% of patients). Patients detected by incidentaloma were older (median age 48 years) than those detected due to clinical suspicion (30 years) (P=0.006). Tumors identified by incidentaloma were significantly larger (median size 65.7 mm) than tumors detected due to adrenergic symptoms/uncontrolled hypertension (55 mm) (P<0.05). There was no difference in catecholamine secretion in the two groups (P=0.13) (the median increase in metanephrines is: 13× ULN in group 1, and 10× ULN in group 2).

Conclusion: Due to the better availability and more frequent use of complementary examinations, the prevalence of incidental pheochromocytomas continues to increase. It would be legitimate to follow a diagnostic approach and adequate care so as not to ignore them.