Endocrine Abstracts

Introduction: Pheochromocytomas may occur sporadically or associated with identifiable genetic syndromes. Reported recurrence rate in sporadic pheochromocytomas in literature is around 3%. There are no consensus guidelines for follow-up of sporadic pheochromocytoma when genetic mutations have been excluded, with varying opinions by ESE, ES and AACE. We aimed to assess characteristics of sporadic phaeochromocytoma patients in our tertiary centre between January 2000-January 2020. Data was gathered on the following characteristics: Age at diagnosis, Sex, genetic testing, presenting symptoms and histology. Follow-up data included: follow-up duration, modalities used, timing of recurrence and survival data.

Results: 64 patients were identified (29 Male, 35 Female). We excluded patients with positive genetics, no local records, and metastatic disease at diagnosis. Age at diagnosis: 18.4-81.2 years. Presenting symptoms were adrenergic (27), adrenal incidentaloma (18) or cardiac symptoms (5). (Insufficient information for 14 patients) On histology review, PASS score was available for 26 patients. Median PASS score was 5 (range 0-10). 18 patients had PASS score ≥4, 8 had PASS score <4. Median follow-up duration was 108 months (range:16 months-389 months). Recurrence was noted in 4 patients, earliest at 41 months and latest 156 months, identified by symptoms (2) and biochemistry (2). Treatments for recurrence included 2 MIBG-therapy, 1 Redo surgery. One patient died prior to treatment. Survival data revealed 11 patients had passed away during follow up period.

Conclusion: This data is in keeping with published data that a small percentage (6%) of patients with sporadic pheochromocytomas will experience recurrent disease. Given the findings, clinical and biochemical surveillance remain reliable ways of identifying recurrence with less frequent imaging. Risk stratifying patients at diagnosis and highlighting at risk groups is important to utilise resources both of those of the patient and NHS.