Phaeochromocytoma with hypercortisolism and hypercalcaemia

Edafe, Ovie; Webster, Jonathan; Fernando, M. A.; Vinayagam, Ragu; Balasubramanian, Sabapathy P

doi:10.1136/bcr-2014-208657

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…It has been suggested that there may be an interaction between the adrenal medulla and cortex. Although coexistent cases of pheochromocytoma and cortisol-secreting adrenocortical adenoma have been previously reported 22 – 24 , it is quite rare. Even rarer, an adrenal corticomedullary mixed tumor has been shown, including in our group 19 .…”

Section: Discussionmentioning

confidence: 98%

Bilateral adrenal uptake of 123I MIBG scintigraphy with mild catecholamine elevation, the diagnostic dilemma, and its characteristics

Inaba

Yamamoto

Urai

et al. 2022

Sci Rep

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Cases in which bilateral adrenal 123I-Metaiodobenzylguanidine (123I-MIBG) scintigraphy accumulation is sometimes shown, with mildly elevated catecholamine (CA) or metanephrine (MN) levels (within 3 times the upper reference limit) are diagnostic dilemmas. We experienced 3 cases of adrenal incidentalomas with this dilemma in the differential diagnosis. The clinical diagnosis was subclinical Cushing's syndrome in 2 cases, and primary aldosteronism in 1. Despite suspected CA excess in clinical symptoms and imaging findings, the pathological findings of all these tumors were revealed to be cytochrome P450 family 11 subfamily B member 1 (CYP11B1) positive adrenocortical adenomas. Interestingly, adrenal medullary hyperplasia (AMH) was detected in the adrenal parenchyma of all those backgrounds. To clarify the clinical features of such cases, a cross-sectional study was conducted at the Kobe University Hospital from 2014 to 2020. One-hundred sixty-four patients who had undergone 123I-MIBG scintigraphy were recruited. Among them, 10 patients (6.1%) met the above criteria, including the presented 3 cases. Plasma adrenaline, noradrenaline, urinary metanephrine, and normetanephrine had values of 0.05 ± 0.05 ng/mL, 0.63 ± 0.32 ng/mL, 0.22 ± 0.05 mg/day, and 0.35 ± 0.16 mg/day, respectively. Nine cases were complicated with hypertension, and symptoms related to CA excess were observed. Half of them (5 cases) including presented 3 cases had unilateral adrenal tumors. These suggest that in cases of bilateral adrenal uptake on 123I-MIBG, AMH needs to be considered. Adrenocortical adenomas may be associated with AMH and further larger investigation is needed for this pathology.

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Section: Discussionmentioning

confidence: 98%

Bilateral adrenal uptake of 123I MIBG scintigraphy with mild catecholamine elevation, the diagnostic dilemma, and its characteristics

Inaba

Yamamoto

Urai

et al. 2022

Sci Rep

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“…As there are numerous effects resulting from aand b-receptor stimulation, PPGL can less commonly present with symptoms including hypercalcaemia and hypercortisolaemia 28 due to the increased secretion of ACTH and thromboembolic events. 29,30 Phaeochromocytoma crisis PPGL crisis is defined as an acute severe presentation of a catecholamine-induced haemodynamic instability causing end-organ damage or dysfunction.…”

Section: Unusual Symptomsmentioning

confidence: 99%

Clinical evaluation and treatment of phaeochromocytoma

et al. 2017

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Phaeochromocytoma and extra adrenal paraganglioma are rare neuroendocrine tumours and have the potential to secrete adrenaline, noradrenaline and dopamine causing a myriad of clinical symptoms. Prompt diagnosis is essential for clinicians and requires a multidisciplinary specialist approach for the clinical and laboratory investigation, diagnosis, treatment and follow-up of patients. This paper is an integrated review of the clinical and laboratory evaluation and treatment of patients suspected to have phaeochromocytoma or paraganglioma, highlighting recent developments and best practices from recent published clinical guidelines.

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Perioperative management of pheocromocytoma/ paraganglioma: a comprehensive review

Román-Conzález

Padilla-Zambrano

Jiménez

2020

Colomb. J. Anesthesiol.

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Pheochromocytomas are rare neuroendocrine neoplasms that require adequate preoperative evaluation in order to prevent and lessen the serious complications of catecholamine hypersecretion. Preoperative management contributes to reducing morbidity and mortality rates in patients who have not been diagnosed with this condition and undergo any surgery. However, current mortality seems to be lower, a fact attributed to preoperative management with alpha blockers.

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Phaeochromocytoma with hypercortisolism and hypercalcaemia

Cited by 3 publications

References 9 publications

Bilateral adrenal uptake of 123I MIBG scintigraphy with mild catecholamine elevation, the diagnostic dilemma, and its characteristics

Bilateral adrenal uptake of 123I MIBG scintigraphy with mild catecholamine elevation, the diagnostic dilemma, and its characteristics

Clinical evaluation and treatment of phaeochromocytoma

Perioperative management of pheocromocytoma/ paraganglioma: a comprehensive review

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