Clinical, imaging and biochemical presentation of cystic pheochromocytomas
Authors' conclusion
Cystic pheochromocytomas are rare, large tumours with a phenotypic appearance that can masquerade as other adrenal cystic lesions. The degree of biochemical abnormality in cystic pheochromocytomas is associated with the volume of the solid component. All patients with adrenal cysts that have a solid component or an unenhanced attenuation >10 HU should undergo biochemical testing for pheochromocytoma.
Study context
- Population
- Patients with cystic pheochromocytoma, single centre, 2000–2020; median age 57 years, 57% womenof 638 with PPGL
- Participants
- 21 patients
- Outcome
- Clinical, imaging and biochemical characteristics
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
- Prevalence of cystic pheochromocytoma among pheochromocytomas
- 21 (3.2%)
- Discovered incidentally
- 57%
- Discovered due to symptoms of catecholamine excess
- 24%
- Median tumour size
- 6.4 cm
- Round or oval
- 90%
- Heterogeneous lesions
- 86%
- Median solid rim thickness
- 13.9 mm
- Solid rim unenhanced computed tomography (CT) attenuation
- 40 Hounsfield units (HU)
- Solid rim venous-phase CT attenuation
- 83 HU
- Median cystic component
- 40%
- Cystic component unenhanced CT attenuation
- 17.6 HU
- Cystic component venous-phase CT attenuation
- 20.4 HU
- Calcifications
- 15%
- Functioning tumours among 20 with biochemical testing
- All 20
- Adrenergic
- 80%
- Noradrenergic
- 20%
- Total urinary metanephrine vs solid component volume
- R2 = .75, p < .0001
- Total urinary metanephrine vs cystic component volume (no correlation)
- R2 = .04, p = .4386
Observational data: associations, not effects.
Further findings
Surgery and hospital stay
- Adrenalectomy
- All patients
- Laparoscopic
- 48%
- Open
- 52%
- Median hospital LOS
- 4 days
Original publication
Clinical, imaging and biochemical presentation of cystic pheochromocytomas. Clin Endocrinol (Oxf). Published 27 April 2022. doi:10.
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