Late recurrence of benign pheochromocytomas: The necessity for long term follow‐up

Sparagana, Mario

doi:10.1002/jso.2930370216

Cited by 13 publications

(5 citation statements)

References 22 publications

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“…Following surgical excision of phaeochromocytoma, there should be annual reviews of blood pressure and symptoms, together with the measurement of urinary catecholamine and/or metanephrine or plasma metanephrine to check for recurrence, metastases or the development of new tumours. Follow‐up at six‐monthly intervals for 15 years, or perhaps for life, following surgery for ‘benign’ phaeochromocytoma has been suggested, 35 but patient compliance with such a regimen is unlikely. Imaging should be used where suspicions are aroused.…”

Section: Discussionmentioning

confidence: 99%

Twelve‐year Experience in the Investigation and Treatment of Paragangliomas

Tormey

Fitzgerald

Davis

et al. 2002

Int J Clinical Practice

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SUMMARYWe report a 12‐year laboratory experience in the diagnosis of 37 patients with phaeochromocytoma, one with malignant paraganglioma and one with ganglioneuroblastoma. Surgery was performed in eight different hospitals, which underlines the difficulty of ensuring uniformity of investigations. Of the 37 with phaeochromocytoma, 15 were in the right adrenal gland, 12 were on the left, seven were bilateral and three were extra adrenal. Twenty‐three were male and 15 were female; the median age was 36 years. Four of five patients with von Hippel‐Lindau disease had bilateral adrenal tumours and four had neurofibromatosis. None had multiple endocrine neoplasia. Using essential hypertensive patients as a reference population, diagnostic sensitivity was 80% for noradrenaline, 54.4% for adrenaline, 19.1% for dopamine, 93.3% for total normetanephrine, 33.3% for total metanephrine, 78.7% for 3‐methoxy‐4‐hydroxymandelic acid (HMMA) and 23.5% for homovanillic acid (HVA). However, if each patient's results were taken as a package, the sensitivities were 100% for noradrenaline, 63.6% for adrenaline, 30.3% for dopamine and 89% for HMMA. Seven recent patients had gene analysis. There were six (15.4%) deaths due directly or indirectly to the paraganglioma. Postoperative blood pressures were normal in 74%. The decrement in catecholamine values post‐surgery is shown. Urinary noradrenaline values fell by a mean of 94.5% and the use of urinary noradrenaline as a tumour marker is also demonstrated.

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Section: Discussionmentioning

confidence: 99%

Twelve‐year Experience in the Investigation and Treatment of Paragangliomas

Tormey

Fitzgerald

Davis

et al. 2002

Int J Clinical Practice

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“…Somit dürften gerade in den jünge-ren Studien mit endoskopischer Operationstechnik die Rückfallquote eher unterschätzt werden. Da das Lokalrezidiv im verbliebenen Nebennierenrest typischerweise erst nach 5-10 Jahren oder gar spä-ter zu erwarten ist [62,70,75], sind für die Beantwortung dieser Frage entsprechende Nachbeobachtungszeiten zu fordern, die naturgemäß aber noch nicht erreicht worden sind (. Tab.…”

Section: > Auch Eine Vollständige Entfernung Der Nebenniere Garantierunclassified

Nebennierenresektion zum Erhalt der adrenokortikalen Funktion

Walz

2009

Chirurg

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The standard procedure for adrenal tumors is total adrenalectomy. In order to preserve adrenocortical function, partial adrenalectomy has become an accepted and proven option in bilateral hereditary pheochromocytomas. For this at least one third of one gland has to be maintained. In unilateral adrenal tumors, partial adrenalectomy has mainly been used in Conn's syndrome. Studies demonstrate results identical to those of total adrenalectomy. All other adrenal tumors are exceptional indications for partial adrenalectomy.

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“…It is quite possible that unsuspected residual or recurrent lesions are being detected with the aid of powerful diagnostic techniques (Samaan et al 1988, Sheps et al 1990, Peplinski & Norton 1994, especially MIBG scanning, which has become available for both the diagnosis and treatment of these tumors (Sisson et al 1984, Geatti et al 1989, Khafagi et al 1991, Krempf et al 1991. Because disease recurrence may take place many years after initial diagnosis (Sparagana 1986, Stenstrom et al 1988, Vassilopoulou-Sellin et al 1993, prolonged surveillance is being instituted more systematically in many centers, leading to increased recognition of the malignant potential for the disease. In our review, we found evidence of malignancy in 42% of sporadic adrenal pheochromocytomas; we consider this figure to represent a likely overestimate of community prevalence resulting from cancer center referral patterns.…”

Section: Neurohumoral Transmission Related Tumorsmentioning

confidence: 99%

Clinical outcome of 50 patients with malignant abdominal paragangliomas and malignant pheochromocytomas

Vassilopoulou‐Sellin¹

1998

Endocrine Related Cancer

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Background: Tumors of the paraganglionic system represent a distinct, albeit uncommon, clinical entity characterized by catecholamine hypersecretion and hemodynamic instability; initial pathologic examination often cannot predict benign vs malignant behavior. An analysis of the clinical outcome of patients with known malignant tumors may serve to enhance the initial evaluation and therapeutic plan of all patients presenting with pheochromocytoma or paraganglioma. Results: Among the 30 patients with paraganglioma, 73% were men, and 90% were younger than 50 years at the time of diagnosis. Sixteen patients have remained alive with persistent disease 0.2 to 25 years after initial diagnosis while eight patients died of their disease within 0.8 to 32 years. Regional recurrence and skeletal metastases were the most prominent events. Among the 20 patients with pheochromocytoma, 60% were men and 70% were younger than 50 years at the time of diagnosis. Ten patients have remained alive with persistent disease 0.8 to 20 years after initial diagnosis while five patients died of their disease within 1.5 to 39 years. Hypertension was a prominent presenting feature and regional recurrence was the most frequent pattern of treatment failure.Conclusions: Important clinical differences distinguish adrenal pheochromocytomas from extraadrenal, abdominal paragangliomas. Patients with paragangliomas are, as a group, younger men, more likely to have malignant lesions and a more aggressive clinical course. Patients with malignant pheochromocytomas usually present with hypertension, are somewhat older, and have less aggresEndocrine-Related Cancer (1998) 5 59-68 sive disease.

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Late recurrence of benign pheochromocytomas: The necessity for long term follow‐up

Cited by 13 publications

References 22 publications

Twelve‐year Experience in the Investigation and Treatment of Paragangliomas

Twelve‐year Experience in the Investigation and Treatment of Paragangliomas

Nebennierenresektion zum Erhalt der adrenokortikalen Funktion

Clinical outcome of 50 patients with malignant abdominal paragangliomas and malignant pheochromocytomas

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