Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2023) 90 P551 | DOI: 10.1530/endoabs.90.P551

ECE2023 Poster Presentations Adrenal and Cardiovascular Endocrinology (72 abstracts)

Does this patient really have a pheochromocytoma? A retrospective analysis of patients undergoing adrenalectomy overdiagnosed with pheochromocytoma

Karolina Zawadzka 1,2 , Piotr Małczak 1 , Michał Wysocki 3 , Piotr Major 1 , Michał Pędziwiatr 1 & Magdalena Pisarska-Adamczyk 4


1Jagiellonian University Medical College, 2nd Department of General Surgery, Kraków, Poland; 2Jagiellonian University Medical College, Doctoral School of Medical and Health Sciences, Kraków, Poland; 3Ludwik Rydygier Memorial Specialized Hospital, Department of General Surgery and Surgical Oncology, Kraków, Poland; 4Jagiellonian University Medical College, Department of Medical Education, Kraków, Poland


Background: Pheochromocytoma and paraganglioma (PPGL) are rare endocrine tumours that secrete catecholamines. Methoxycatecholamines in free plasma or fractionated methoxycatecholamines in 24-hour urine collections are the recommended tests for the diagnosis of pheochromocytoma, based on which patients are referred for surgical removal of the adrenal gland. However, false-positive results from these tests remain a problem and some patients are referred for adrenalectomy due to suspected pheochromocytoma, but the verifying histopathological examination does not confirm the diagnosis.

Aim: The aim of the study was to assess the characteristics of patients overdiagnosed as pheochromocytoma and undergoing treatment with adrenalectomy.

Methods: Data from 107 adult patients, who underwent laparoscopic adrenalectomy for suspected pheochromocytoma between January 2012 and December 2022, were retrospectively analysed. The patients were divided into two groups: the first, in which the postoperative histopathological examination confirmed the diagnosis of pheochromocytoma (n=74), and the second, in which the suspicion of pheochromocytoma was not confirmed (n=33).

Results: Following histopathological examination of the postoperative material, the diagnosis for 30.8% of the tumours clinically suspected as pheochromocytoma was reclassified. The tumours that were most frequently over-diagnosed as pheochromocytomas were adrenocortical adenomas (n=16) and adrenocortical hyperplasia (n=10). In addition, 3 adrenocortical carcinomas, 1 oncocytic tumour, 1 myelolipoma, 1 metastatic neuroendocrine carcinoma and 1 completely normal adrenal gland were misclassified as pheochromocytoma. Patients with histopathologically confirmed pheochromocytoma were younger (median 56, IQR 23 years vs median 63, IQR 8 years, P=0.027) and had a lower BMI (median 26, IQR 6.4 kg/m2 vs median 29.6, IQR 7.6 kg/m2, P<0.001). In addition, patients with pheochromocytomas had significantly higher concentrations of metanephrine (median 1119.5, IQR 2868 vs median 175.2, IQR 136 µL/24 h, P<0.0001) and normetanephrine (median 4399.4, IQR 4703 vs median 659.73, IQR 501.9 µL/24 h, P<0.0001) determined in the daily urine collection. There were no statistically significant differences between tumours histopathologically confirmed as pheochromocytoma and false-positive pheochromocytoma with regard to sex, methoxytyramine levels, morning and evening cortisol levels, aldosterone, plasma renin activity, adrenocorticotropic hormone. The size of the adrenal gland on preoperative CT scan and the size of the tumour on histopathology were also not significantly different between groups.

Conclusions: There is still a considerable number of patients undergoing adrenalectomy for suspected pheochromocytoma in whom histopathological verification does not confirm the initial diagnosis. A significant proportion of these are benign tumours that do not need surgical treatment.

Volume 90

25th European Congress of Endocrinology

Istanbul, Turkey
13 May 2023 - 16 May 2023

European Society of Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.