Predictors of recurrence in pheochromocytoma

Press, Danielle; Akyüz, Muhammet; Dural, Ahmet Cem; Aliyev, Shamil; Monteiro, Rosebel; Mino, Jeffrey; Mitchell, Jamie; Hamrahian, Amir H.; Siperstein, Allan; Berber, Eren

doi:10.1016/j.surg.2014.08.044

Cited by 37 publications

(26 citation statements)

References 14 publications

(20 reference statements)

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“…Recurrence of PHEOs aft er resection occurs in 6.5-16.5% of patients (van Heerden et al 1990;Amar et al 2005;Shen et al 2010;Amar et al 2012;Press et al 2014) and can be local in the adrenal bed (Brennan and Keiser 1982). Distant recurrences are caused by second primary tumors, such as in the contra lateral gland; metastatic disease, such as in the bone or lung; or gross tumor spillage at the initial operation (Brennan and Keiser 1982).…”

Section: Surgery Of Pheochromocytomamentioning

confidence: 99%

“…Th erefore, prompt recognition of recurrence is important (Press et al 2014). In a study by Press et al (2014), they found that tumor size >5 cm was an independent predictor of recurrence and concluded that: Patients with large tumors (>5 cm) should be followed vigilantly for recurrence.…”

Section: Surgery Of Pheochromocytomamentioning

confidence: 99%

“…In a study by Press et al (2014), they found that tumor size >5 cm was an independent predictor of recurrence and concluded that: Patients with large tumors (>5 cm) should be followed vigilantly for recurrence. Because 25% of patients with recurrence had normal biochemical levels, they recommend routine imaging and testing of plasma or urinary metanephrines for prompt diagnosis of recurrence (Press et al 2014).…”

Section: Surgery Of Pheochromocytomamentioning

confidence: 99%

“…With regard to surveillance postoperatively, Press et al (2014) recommend that it is the laboratory values that should be obtained within the fi rst month aft er surgery, again at 6 months, and 1 year, and imaging at 1 year. Laboratory values should be obtained annually, thereaft er if everything appears normal (Press et al 2014).…”

Section: Postoperative Surveillancementioning

confidence: 99%

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Pheochromocytoma, diagnosis and treatment: Review of the literature

Farrugia

Martikos

Tzanetis

et al. 2017

Endocrine Regulations

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Objective. We conducted an extensive review of the literature and tried to cite the most recent recommendations concerning the pheochromocytoma (PHEO).Methods. Pub Med and Google Scholar databases were searched systematically for studies concerning pheochromocytomas (intra-adrenal paragangliomas) from 1980 until 2016. Bibliographies were searched to fi nd additional articles.Results. More than four times elevation of plasma fractionated metanephrines or elevated 24-h urinary fractionated metanephrines are keys to diagnosing pheochromocytoma. If the results are equivocal then we perform the clonidine test. If we have not done it already, we preferably do a CT scan and/or an MRI scan. Th e patient needs pre-treatment with α1-blockers at least 10-14 days before operation. Alternatives or sometimes adjuncts are Calcium Channels Blockers and/ or β-Blockers. Several familial syndromes are associated with PHEO and genetic testing should be considered.Conclusions. Th e biggest problem for pheochromocytoma is to suspect it in the fi rst place. Elevated metanephrines establish the diagnosis. With the proper preoperative preparation the risks during operation and the postoperative period are minimal. If there is a risk of the hereditable mutation, it is strongly suggested that all the patients with pheochromocytoma need clinical genetic testing.

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Section: Surgery Of Pheochromocytomamentioning

confidence: 99%

Section: Surgery Of Pheochromocytomamentioning

confidence: 99%

Section: Surgery Of Pheochromocytomamentioning

confidence: 99%

Section: Postoperative Surveillancementioning

confidence: 99%

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Pheochromocytoma, diagnosis and treatment: Review of the literature

Farrugia

Martikos

Tzanetis

et al. 2017

Endocrine Regulations

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“…Bár más hazai centrumok hasonló adatai nem ismertek, felté-telezhetjük, hogy a phaeo-PGL hazánkban még napja- inkban is aluldiagnosztizált. Minden bizonnyal erre utal az is, hogy a phaeo-PGL betegcsoportra jellemző 1:1 körüli nő/férfi arány [8,12,20] betegeink körében erő-sen a nők javára tolódott el. Eredményeink alapján az örökletes phaeo-PGL gyakorisága megközelíti a legújabb vizsgálatok által jelzett átlagosan 33,8%-ot [6].…”

Section: Megbeszélésunclassified

Analysis of laboratory data of 155 patients with pheochromocytoma-paraganglioma syndrome diagnosed during the past 20 years

et al. 2015

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Bevezetés: A phaeochromocytoma-paraganglioma szindróma laboratóriumi kórismézése jelentős fejlődésen ment keresztül az utóbbi két évtizedben. Célkitűzés: Jelen vizsgálat célja, hogy retrospektív elemzéssel bemutassa és értékelje a Semmelweis Egyetem, II. Belgyógyászati Klinikán 1993-2013 között diagnosztizált phaeochromocytomás/paragangliomás betegek klinikai és laboratóriumi adatait. Módszer: A vizeletkatecholaminokat és metabolitjaikat nagy felbontású folyadékkromatográfiát követő elektrokémiai detektálással mérték 155 phaeochromocytoma-paraganglioma szindrómás (28,4%-uk örökletes hátterű) betegben és 170 nem phaeochromocytomás egyénben. A szérum-chromogranin-A-t immunradiometriás módszerrel vizsgálták. Eredmények: A 24 órás gyűjtött vizeletben a frakcionált metanephrinek szenzitivitása (93,2%) és specificitása (87,0%) meghaladta a katecholaminok (90,9% és 85,7%) és a szérum-chromogranin-A-meghatározás (88,7%, illetve 77,5%) hasonló értékeit. A vizeletnormetanephrin, illetve a szérum-chromogranin-A pozitív összefüggést mutatott a daganatátmérővel (r = 0,552, p<0,0001, illetve r = 0,618, p<0,0001). Következtetések: Az eredmények a vizelettel ürülő katecholaminmetabolitok meghatározásának jelentősé-gét igazolják a phaeochromocytoma-paraganglioma diagnosztikájában. A vizeletnormetanephrin és a szérum-chromogranin-A segíthet a tumortömeg és a progresszió megítélésében. Orv. Hetil., 2015, 156(16), 626-635. Kulcsszavak: phaeochromocytoma, paraganglioma, katecholaminürítés, chromogranin-A Analysis of laboratory data of 155 patients with pheochromocytomaparaganglioma syndrome diagnosed during the past 20 yearsIntroduction: Laboratory diagnosis of pheochromocytoma-paraganglioma syndrome has been markedly improved during the past two decades. Aim: Retrospective assessment of diagnostic utility of urinary catecholamines and their metabolites as well as serum chromogranin A in 155 patients diagnosed at the 2nd Department of Medicine, Semmelweis University. Method: Urinary catecholamines and metabolites were measured using high-performance liquid chromatography with electrochemical detection in 155 patients with pheochromocytoma-paraganglioma (of whom 28.4% had hereditary background) and in 170 non-pheochromocytoma patients used as controls. Serum chromogranin A was measured by immunoradiometry. Results: Sensitivity (93.2%) and specificity (87.0%) of urinary fractionated metanephrines were higher than those of urinary catecholamines (90.9% vs. 85.7%, respectively) and serum chromogranin A (88.7% and 77.5%, respectively). Urinary normetanephrine and serum chromogranin A correlated positively with tumor size (r = 0.552, p<0.0001 and r = 0.618, p<0.0001, respectively). Conclusions: These data confirm the diagnostic utility of urinary catecholamines and their metabolites. Urinary normetanephrine and serum chromogranin A may help to estimate tumour mass and probably tumour progression.

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Malignant Tumors of the Adrenal Gland

Lee¹,

Habra²,

Campbell³

2022

Holland‐Frei Cancer Medicine

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Overview Optimal evaluation and treatment of malignant or potentially malignant adrenal tumors including pheochromocytoma/paraganglioma and adrenal cortical carcinoma can be complex. It requires appropriate diagnostic imaging and endocrine hormone evaluation, and benefits from expert multidisciplinary coordination, by medical oncologists, endocrinologists, and surgeons, as well as additional specialists, for example genetic counselors. Recent advances in diagnostic imaging, including functional imaging such as PET, have facilitated early detection and diagnosis, enhanced the accuracy of staging, and improved treatment planning. Good‐risk patients with resectable localized, recurrent, or limited metastatic disease are usually recommended to undergo either minimally invasive or open surgery. Advances in minimally invasive and open surgical techniques have improved surgical outcomes. There is no defined role for adjuvant therapy following resection of pheochromocytoma/paraganglioma. Adjuvant therapy for patients with adrenal cortical carcinoma, most commonly single‐agent mitotane, is considered selectively. Systemic treatment options for patients with locally recurrent, unresectable, or metastatic malignant adrenal carcinoma include targeted treatments for patients with metastatic pheochromocytoma/paraganglioma, and combination chemotherapy with or without mitotane for patients with adrenal cortical carcinoma. Radiation therapy for patients with malignant adrenal tumors of either histology is also employed selectively. Emerging genetic and molecular data, as well as clinical trials, increasingly inform treatment strategies and choice of systemic therapy.

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Predictors of recurrence in pheochromocytoma

Cited by 37 publications

References 14 publications

Pheochromocytoma, diagnosis and treatment: Review of the literature

Pheochromocytoma, diagnosis and treatment: Review of the literature

Analysis of laboratory data of 155 patients with pheochromocytoma-paraganglioma syndrome diagnosed during the past 20 years

Malignant Tumors of the Adrenal Gland

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