Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 29 P123

ICEECE2012 Poster Presentations Adrenal medulla (15 abstracts)

Features at presentation of adrenal pheochromocytomas in castilla la mancha (spain). Is the clinical spectrum changing ?

E. Maqueda 5 , A. Vicente 5 , M. Aguirre 2 , L. Louhibi 1 , I. Gómez 3 , M. Alramadán 4 , C. Roa 7 & V. Alvarez de Frutos 6


1General Universitario, Albacete, Spain; 2Hospital General, Ciudad Real, Spain; 3Hospital General La Mancha Centro, Alcázar de San Juan, Spain; 4Hospital Virgen de la Luz, Cuenca, Spain; 5Hospital Virgen de la Salud, Toledo, Spain; 6Hospital Universitario, Guadalajara, Spain; 7Hospital Santa Bárbara, Puertollano, Spain.


Background: Typical presentation of adrenal pheochromocytomas (PHEOs) is a combination of variable hypertension with paroxysmal symptoms. However, recent improvements in diagnostic imaging techniques and increasing availability of genetic testing have facilitated presymptomatic diagnosis of PHEOs.

Objetive: To analyse the clinical features at presentation of PHEOs in a multicentric study population.

Design and patients: Seven Spanish endocrine centres participated in this study. Medical records of 69 patients who were diagnosed of PHEO between 1991 and 2011 were reviewed.

Results: 34 were male and 35 were female. Mean age at diagnosis was 52.11 years (17–78). Typical triad of symptoms was found only in 18.6% of cases. Nine patients (12.9%) were diagnosed during hypertension study. Hypertensive crises during diagnostic or surgical procedures occurred in 10.1% of cases. Thirty two patients (45.7%) were incidentally discovered. 5 cases were diagnosed before 2000, and 27 after this year. These patients were significantly older than patients in whom the diagnosis was suspected on clinical grounds. (57.6±12.2 vs 46.8±17.3 years; P<0.01) The mean size of incidental PHEOs were 4.79±2 cm, smaller than the mean size of the whole study group PHEOs (5.35±3.29 cm). Seventeen genetic testing were done (seven negative and ten positive: nine MEN2 and one Von Hippel Lindau). Three patients (4,3%) was discovered by this way. Patients with positive genetic study were significantly younger (32.1±11.4 vs 52.1±16 years; P< 0.001). Six patients (8.7%) had bilateral tumors; four of these were found to have MEN2. Only one patient had metastasic disease at the time of diagnosis.

Conclusions: In our study group, presymptomatic diagnosis were done in a half of the patients with PHEOs. Frecuency of incidentally discovered PHEOs seemed to be increasing over time and familial PHEO was found in a significant proportion of the patients. Every adrenal incidentaloma should be investigated for the presence of PHEO and genetic testing should be considered in patients with a family history, young age, or multifocal, bilateral, extra-adrenal, or malignant tumors.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

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