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Pheochromocytoma Characteristics and Behavior Differ Depending on Method of Discovery
Lucinda M Gruber1, Robert P Hartman2, Geoffrey B Thompson3
1Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, Minnesota.
The Journal of Clinical Endocrinology and Metabolism
|November 22, 2018
Summary
Pheochromocytomas (PHEOs) are often incidentally found. PHEOs detected via genetic testing are smaller and need less medication, supporting routine genetic screening for predisposed individuals.
Area of Science:
- Endocrinology
- Oncology
- Genetics
Background:
- Pheochromocytomas (PHEOs) are neuroendocrine tumors often discovered incidentally.
- Limited understanding exists regarding the behavior of PHEOs found through incidental imaging or genetic testing.
Purpose of the Study:
- To characterize the clinical presentation and behavior of PHEOs identified incidentally or via mutation-based genetic testing.
Main Methods:
- Retrospective analysis of 296 PHEOs from 271 patients treated between 2005 and 2016.
- Evaluation of tumor size, biochemical markers (metanephrines, catecholamines), and preoperative management based on discovery method.
Main Results:
- Incidental findings accounted for 61% of PHEO discoveries, followed by symptoms (27%) and genetic testing (12%).
- PHEOs found via genetic testing were smaller and required less preoperative alpha-adrenergic blockade compared to symptomatic PHEOs.
- Symptomatic PHEOs exhibited higher levels of urinary and plasma metanephrines.
Conclusions:
- Pheochromocytomas are predominantly discovered incidentally.
- Genetic testing identifies smaller PHEOs requiring less preoperative management, supporting its routine use in genetically predisposed individuals.
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