Pheochromocytomas Most Commonly Present As Adrenal Incidentalomas: A Large Tertiary Center Experience
Authors' conclusion
The majority of pheochromocytomas are diagnosed incidentally and have distinct clinical, radiological, biochemical, and genetic features. Their detection at older age but smaller size may point to a different underlying tumor biology.
Study context
- Population
- Patients with pheochromocytoma seen January 2010–October 2022 at a large UK tertiary care center; diagnosis confirmed histologically or by increased plasma and/or urinary metanephrines (MN), indeterminate adrenal mass on imaging and MIBG avidity144 underwent adrenalectomy
- Participants
- 167 patients
- Exposure
- Incidentally detected vs clinically suspected (adrenergic symptoms/uncontrolled hypertension) vs genetic-screening-detected pheochromocytomas
- Incidentaln = 91
- Symptomatic/uncontrolled hypertensionn = 37
- Genetic screeningn = 20
- Outcome
- Proportion of incidental pheochromocytomas
Methodological detailssingle-centre, tertiary care centre
- Single-centre
- Tertiary care centre
Main finding
As reported in the abstract
Mode of presentation (excluding genetic screening, n = 132)
Observational data: associations, not effects.
Further findings
| Outcome | Incidental | Symptomatic/uncontrolled hypertension | Genetic screening | P value |
|---|---|---|---|---|
| AgeIncidental vs Symptomatic/uncontrolled hypertension · incidental older | median 62 years | 42 years | 33 years | P < 0.05 |
| AgeIncidental vs Genetic screening · incidental older | P < 0.05 | |||
| Tumour sizeIncidental vs Symptomatic/uncontrolled hypertension · incidental smaller | median 42 mm | 60 mm | 30 mm | P < 0.05 |
| Tumour sizeIncidental vs Genetic screening · incidental larger | P < 0.05 | |||
| Hereditary predisposition | 15.3% | 42.9% | — not stated in the abstract |
— not stated in the abstract
- Hereditary predisposition — All patients
- 20.4%
- Age: all P < .05
- Tumour size: all P < .05
Increased MN excretion
- Symptomatic/uncontrolled hypertension > incidental > genetic screening (all P < .05)
Original publication
Pheochromocytomas Most Commonly Present As Adrenal Incidentalomas: A Large Tertiary Center Experience. J Clin Endocrinol Metab. Published 7 July 2023. doi:10.
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