Pre- and post-operative metabolic profile of patients with pheochromocytoma: A retrospective multicenter study

To evaluate the metabolic dysregulation of patients with pheochromocytoma and their metabolic evolution after tumor resection.

This multicenter, retrospective study included individuals diagnosed and treated for pheochromocytoma at four Greek tertiary hospitals over the past twenty-five years. Clinical data were collected from medical records and compared according to catecholamine phenotypes, incidentaloma diagnosis and hypertensive status. Correlation analysis was performed between metabolic and pheochromocytoma-related characteristics. The evolution of metabolic profiles was assessed before and after adrenalectomy.

A total of 117 patients were included (median age 51 years, 59.0% female). At diagnosis, the prevalence of diabetes/prediabetes, dyslipidemia and obesity was 58.1%, 65.0% and 19.7%, respectively. Adrenergic phenotype was predominant in older individuals (p = 0.004) and required significantly higher daily doses of phenoxybenzamine (p = 0.01). Metabolic and tumor parameters did not differ between catecholamine phenotypes. Patients with incidentalomas exhibited a higher prevalence of diabetes in comparison to their non-incidentaloma counterparts (p = 0.03), while the lipid profile did not differ between groups. Hypertensive patients had larger tumors (p = 0.01) with higher PASS (p = 0.012). Ninety-three patients were followed-up after adrenalectomy for a median period of 24 months. Postoperatively, the prevalence of hypertension and diabetes decreased with significant improvements in serum HbA1c, fasting glucose, cholesterol and LDL levels, despite no significant change in body mass index (BMI).

Pheochromocytomas were associated with a high cardiometabolic burden. Metabolic profiles did not differ between catecholamine phenotypes, while adrenalectomy led to significant improvements in metabolic parameters despite stable BMI.