Endocrine Abstracts

JOINT2953

Introduction: Pheochromocytomas and paragangliomas are rare neuroendocrine tumors that develop from chromaffin cells located in the adrenal medulla and neural ganglia. The incidence of these tumors ranges from 0.04 to 0.95 per 100,000 individuals annually, with an increase in diagnoses attributed to advancements in imaging technologies. Both the clinical presentation and management of these tumors are highly variable, posing challenges in early detection, biochemical assessment, and treatment.

Subjects and methods: This retrospective descriptive study was conducted on 17 patients diagnosed with pheochromocytomas or paragangliomas at the Endocrinology and Diabetology Department of Tunis Military Hospital from 2013 to 2024. The study analyzed various parameters, including demographic features, clinical findings, biological aspects, radiological assessments, and post-operative follow-up.

Results: The study involved 17 patients, consisting of 10 females (58.8%) and 7 males (41.2%). The median age at diagnosis was 49 years, ranging from 33 to 62 years. The main circumstances leading to the diagnosis included paroxysmal symptoms in 41.2% of patients and incidental findings in 58.8%. Sixteen patients had pheochromocytomas (94.1%) while one had a paraganglioma (5.9%). Hypertension was prevalent among participants; 64.7% experienced permanent hypertension, while 23.5% had resistant hypertension. Other common symptoms included headaches (76.5%), sweating (76.5%), palpitations (70.6%), and abdominal pain (29.4%). Biologically, normetanephrine secretion was predominant in 50% of cases, while 33.3% of patients exhibited exclusive metanephrine secretion. Functional imaging revealed single hyperfixation in 88.9% of cases. The median tumor size was 52.5 mm, ranging from 46.25 mm to 65.25 mm, and the median absolute washout was 35%, ranging from 23% to 49.45%. Additionally, no patient presented with metastatic tumors. Surgical treatments were performed through laparotomy in 82.4% of cases and laparoscopy in 17.6%. Postoperatively, blood pressure normalized in 44.4% of patients, while 33.3% experienced recurrent hypertension. Metabolically, diabetes worsened in 28.6% of patients. Three months later, 14 participants had normalization of methoxylated derivatives, while the remaining were lost to follow-up. Our findings align with the existing literature on demographic trends, clinical presentations, and biochemical profiles. There is variability in the management of hypertension, surgical techniques, and metabolic outcomes.

Conclusion: Pheochromocytomas and paragangliomas have diverse clinical and biochemical profiles, complicating their diagnosis and treatment. While surgery is the main treatment of these tumors, outcomes can vary, particularly for hypertension and diabetes. Long-term follow-up is crucial to monitor recurrence and manage metabolic complications.