Resection of Pheochromocytoma Improves Diabetes Mellitus in the Majority of Patients

Beninato, Toni; Kluijfhout, Wouter P.; Drake, Frederick Thurston; Lim, James W.; Kwon, Julie S.; Xiong, Maggie; Shen, Wen T.; Gosnell, Jessica E.; Liu, Chien-Ying; Suh, Insoo; Duh, Quan‐Yang

doi:10.1245/s10434-016-5701-6

Cited by 39 publications

(41 citation statements)

References 11 publications

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“…Furthermore, it is important to reiterate that there has been convincing proof of the strong relationship between impaired glucose metabolism, IR, and cardiovascular events. A consistent finding of many studies is the remarkable amelioration of blood glucose levels and IR after surgical treatment (61)(62)(63)(64). Therefore, those patients with adrenal diseases presenting operative indications should receive surgery without delay.…”

Section: Discussionmentioning

confidence: 61%

Assessment of Glycometabolism Impairment and Glucose Variability Using Flash Glucose Monitoring System in Patients With Adrenal Diseases

et al. 2020

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Background: This study aimed to investigate the characteristics and extent of glycometabolism impairment in patients with adrenal diseases, including Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonfunctional adrenal incidentaloma. Methods: This study enrolled thirty-two patients with adrenal diseases as adrenal disease groups and eight healthy individuals as healthy controls. Blood glucose levels were indicated by glucose concentration in interstitial fluid, which was documented using flash glucose monitoring system. According to flash glucose monitoring system data, parameters representing general blood glucose alterations, within-day and day-today glucose variability, and glucose-target-rate were calculated. Furthermore, blood glucose levels at nocturnal, fasting, and postprandial periods were analyzed. Besides, islet b-cell function and insulin resistance were assessed.

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Section: Discussionmentioning

confidence: 61%

Assessment of Glycometabolism Impairment and Glucose Variability Using Flash Glucose Monitoring System in Patients With Adrenal Diseases

et al. 2020

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“…Beninato et al reported the outcomes of 153 patients with pheochromocytoma who underwent surgical resection, and diabetes was observed in 36 (23.4%) patients [5]. Overall, 93% of these patients showed improvement in their diabetes after surgical resection.…”

Section: Discussionmentioning

confidence: 99%

Surgical resection of a middle mediastinal paraganglioma that caused diabetes

2020

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Background Paragangliomas are rare neuroendocrine tumors originating from chromaffin cells of extra-adrenal origin. Ninety percent of adrenergic tumors originate in the adrenal medulla and are known as pheochromocytomas; the remaining 10% are extra-adrenal and are called paragangliomas. Mediastinum paragangliomas is rare and commonly originate from the posterior mediastinum, while those originating from the middle posterior are quite rare. Some paragangliomas secrete catecholamines, leading to symptoms such as hypertension, tachycardia, and diabetes. Case presentation A 76-year-old woman visited our hospital for the treatment and further evaluation of diabetes. Her hemoglobin A1c levels had risen to 11.0%. To investigate the cause of her diabetes, a contrast-enhanced chest computed tomography scan was performed, revealing a ring-enhancing tumor (30 × 30 mm) in the middle mediastinum. The surgical resection was performed via video-assisted thoracic surgery. Surgery was performed using a vessel-sealing device; however, bleeding was persistent from the surrounding tissue. Total bleeding was 400 g. Blood pressure fluctuations and arrhythmia did not occur during the operation. The patient’s uncontrolled diabetes was cured after the surgery, and the tumor was diagnosed as a functional paraganglioma. Conclusions We encountered a rare case of functional paraganglioma located in the middle mediastinum. Functional paragangliomas should be considered as a potential cause of uncontrolled diabetes, and a whole-body CT scan should be performed to investigate this possible cause.

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“…While cortisol is the most common hormone secreted, the onset of catecholamine secretion over time seems extremely rare (3), with only a few cases reported to date (4)(5)(6)(7)(8). In a study of Cho et al (6) (9,10). This manifestation is mediated by a multitude of mechanisms, including increased insulin resistance in peripheral tissues, impaired insulin secretion and glucose uptake (11).…”

Section: Discussionmentioning

confidence: 99%

Tako-tsubo Syndrome as First Manifestation in a Case of Pheochromocytoma Developed From a Non-functional Adrenal Incidentaloma

et al. 2020

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Background: Pheochromocytoma is a catecholamine secreting tumor that, in extremely rare cases, may develop over time from a non-functional adrenal adenoma. Catecholamine excess can lead to a kind of cardiomyopathy similar to that seen in tako-tsubo syndrome (TTS). Case report: A 69 years old female with a history of type 2 diabetes, hypertension, and a non-functional right adrenal adenoma diagnosed 3 years earlier was referred to our center for further investigations. During the evaluation, she had a hypertensive crisis with chest pain, tachycardia, and diaphoresis. Suspecting an acute coronary syndrome, she underwent coronary angiography, which showed the typical features of TTS. The high 24 h-urinary metanephrines excretion and abdominal MRI findings were suggestive of pheochromocytoma. Right laparoscopic adrenalectomy was performed, with the resolution of all symptoms. Pathology findings confirmed the diagnosis of pheochromocytoma. After 12 months, the patient was still asymptomatic, with the echocardiography displaying a complete recovery of the left-ventricular function. Conclusions: The development of a pheochromocytoma from an adrenal non functional adenoma is an extremely rare event, but potentially life-threating because of the catecholamine-associated cardiovascular toxicity. In particular, TTS is a form of cardiomyopathy that has been increasingly described as associated with catecholamine-secreting tumors. The exclusion of pheochromocytoma in a patient with TTS has important therapeutic implications, since the administration of β-blockers may be extremely harmful in patients with catecholamine surge in the absence of adequate α-blockage.

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Resection of Pheochromocytoma Improves Diabetes Mellitus in the Majority of Patients

Cited by 39 publications

References 11 publications

Assessment of Glycometabolism Impairment and Glucose Variability Using Flash Glucose Monitoring System in Patients With Adrenal Diseases

Assessment of Glycometabolism Impairment and Glucose Variability Using Flash Glucose Monitoring System in Patients With Adrenal Diseases

Surgical resection of a middle mediastinal paraganglioma that caused diabetes

Tako-tsubo Syndrome as First Manifestation in a Case of Pheochromocytoma Developed From a Non-functional Adrenal Incidentaloma

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