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[Pheochromocytomas and CT: can size predict malignancy?]
F Mignon1, B Mesurolle, A Laplanche
1Service de radiologie, Hôpital Mignot, 177, rue de Versailles, 78157 Le Chesnay, France. fmignon@ch-versailles.fr
Objectives:
The purpose of this study was to determine clinical and imaging findings associated with malignancy in pheochromocytomas.
Material:
and methods. A multicentric retrospective CT study including 50 lesions (23 benign and 27 malignant histologically proven pheochromocytomas) was conducted. The diagnosis of malignancy was based on histological criteria (capsular rupture, local invasion), on synchronous metastases or on the occurrence of locoregional recurrences or metastases during the outcome. The analysis was based on clinical data (age, sex, secretion of the lesion and hypertension) and on radiological criteria (largest diameter of the tumor, side, homogeneity, regularity and sharpness of contours).
Results:
A statistical difference was found between the median largest diameter, the regularity and sharpness of contours benign and malignant lesions (p<0.0001); other clinical and radiological criteria being non significantly different. A largest diameter greater than 45 mm enabled to suggest malignancy with a sensitivity of 100% and a specificity of 69%.
Conclusion:
A diameter larger than 50mm, presence of a locoregional invasion and of metastases are strong arguments favouring.