Management of 3 Cases of Pheochromocytoma During the COVID-19 Pandemic in New York City: Lessons Learned

Japp, Emily; Leiter, Amanda; Tsomos, Effie; Reda, Sarah; Levine, Alice C.

doi:10.1210/jendso/bvaa198

Cited by 7 publications

(14 citation statements)

References 12 publications

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“…e unusual circumstances created by the pandemic necessitated a more prolonged preoperative period of medical management, as already described in other 4 cases recently reported [6,7]. At last, the adrenal tumor was successfully resected after a prolonged pharmacologic control of blood pressure, and the patient is doing well off antihypertensive treatment.…”

Section: Discussionmentioning

confidence: 84%

A Tale of Two Hypersecreting Adrenal Neoplasms in the Heartland of COVID-19 Pandemic, Lombardy, Italy

Zampetti

Attanasio

Carioni

et al. 2022

Case Reports in Endocrinology

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Section: Discussionmentioning

confidence: 84%

A Tale of Two Hypersecreting Adrenal Neoplasms in the Heartland of COVID-19 Pandemic, Lombardy, Italy

Zampetti

Attanasio

Carioni

et al. 2022

Case Reports in Endocrinology

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“…Importantly, our patient was completely normotensive, and apart from sweating, not all the other symptoms would certainly arouse suspicion of PCC. While clinicians often put too much emphasis on the presence of hypertension, the absence of a positive history of hypertension in our patient might have contributed to the lack of suspicion of a catecholamine-producing tumor, hindering the timely treatment of this potentially life-threatening tumor (11,12).…”

Section: Discussionmentioning

confidence: 95%

“…In contrast to the present case, these patients had complications during acute infection. Therefore, prompt and adequate treatment of these patients is of utmost importance to avoid severe outcomes and comorbidities such as stroke, myocardial infarction, circulatory collapse, and death from superimposed risks ( 8 , 9 , 11 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Incidentally discovered case of pheochromocytoma as a cause of long COVID-19 syndrome

et al. 2022

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Pheochromocytomas (PCCs) are rare but potentially lethal tumors that arise from the adrenal medulla. The clinical suspicion and diagnosis of PCC can be challenging due to the non-specific nature of signs and symptoms. In many patients, infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could lead to long-term symptoms including fatigue, headaches, and cognitive dysfunction. Here, we present the case of a patient incidentally diagnosed with an adrenal mass that proved to be a PCC after imaging was performed due to persisting complaints after coronavirus disease 2019 (COVID-19) infection. A 37-year-old male patient was referred to our center because of a right-sided inhomogeneous adrenal mass, incidentally found during a computed tomographic scan of the thorax performed due to cough and dyspnea that persisted after COVID-19 infection. Other complaints that were present prior to COVID-19 infection included profuse sweating, dizziness, exhaustion with chronic fatigue, and concentration difficulties. The patient had no history of hypertension, his blood pressure was normal, and the 24-h ambulatory blood pressure monitoring confirmed normotension but with the absence of nocturnal dipping. Plasma normetanephrine was 5.7-fold above the upper limit (UL) of reference intervals (738 pg/ml, UL = 129 pg/ml), whereas plasma metanephrine and methoxytyramine were normal at 30 pg/ml (UL = 84 pg/ml) and <4 pg/ml (UL = 16 pg/ml), respectively. Preoperative preparation with phenoxybenzamine was initiated, and a 4-cm tumor was surgically resected. Profuse sweating as well as dizziness was resolved after adrenalectomy pointing toward PCC and not COVID-19-associated patient concerns. Altogether, this case illustrates the difficulties in recognizing the possibility of PCC due to the non-specific nature of signs and symptoms of the tumor, which in this case did not include hypertension and coincided with some of the symptoms of long COVID-19.

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“…After that, the use of telemedicine and remote counselling increased, as in many other countries [12,13]. However, even conservative med-ical treatment of pheochromocytoma during the pandemic has been described [14].…”

Section: Discussionmentioning

confidence: 99%

The Impact of the COVID Pandemic on Adrenal Surgery at an Academic Endocrine Surgery Unit

Chiapponi,

Faust,

Schmidt

et al. 2023

Horm Metab Res

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COVID-19 has severely affected the delivery of surgical care worldwide. The aim of the present study was to evaluate its impact on adrenal surgery at our academic endocrine center. All primary adrenal surgeries performed at the University Hospital of Cologne, Germany between 01.01.2019 and 31.07.2022 were included. This time frame was divided into pre-Covid (before 02/20), acute Covid (until 05/21), and post acute period (after 05/2021). Demographics, clinic-pathologic characteristics and treatment of these patients were analyzed. One hundred adrenalectomies were included: 22 before, 30 during, and 48 after the acute phase. The percentage of Conn adenomas and pheochromocytomas decreased during the acute phase (from 45.4 to 26.6% and from 18 to 10%, respectively) in favor of Cushing adenomas and suspicious tumors (from 4.5 to 20% and from 31.8 to 36.6%). About 90.9% of tumors resected for suspicion of malignancy were confirmed malignant by final histopathology, as opposed to 71.4% and 52.6% before and after the acute phase. The operative technique was similar during the three phases (63% retroperitoneoscopic, 34% laparoscopic and 2% open resections), with a significantly shorter operative time for retroperitoneoscopy (p=0.04). ICU monitoring demand increased during the acute phase (from 13.6% to 43.3%), according to the increase in Cushing adenomas and malignant tumors. During the acute phase of COVID-19 pandemic adrenal surgery for Cushing and malignant tumors increased, while a delay in pheochromocytoma surgery to the post acute phase was observed. The suspicion of malignancy formulated by the endocrine tumor board was accurate in 90.9% of cases.

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Management of 3 Cases of Pheochromocytoma During the COVID-19 Pandemic in New York City: Lessons Learned

Cited by 7 publications

References 12 publications

A Tale of Two Hypersecreting Adrenal Neoplasms in the Heartland of COVID-19 Pandemic, Lombardy, Italy

A Tale of Two Hypersecreting Adrenal Neoplasms in the Heartland of COVID-19 Pandemic, Lombardy, Italy

Case report: Incidentally discovered case of pheochromocytoma as a cause of long COVID-19 syndrome

The Impact of the COVID Pandemic on Adrenal Surgery at an Academic Endocrine Surgery Unit

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