The Clinical Characteristics of Pheochromocytomas and Paragangliomas with Negative Catecholamines

Abstract

Pheochromocytomas and paragangliomas (PPGLs) associated with negative catecholamines are not uncommon. However, few studies have examined clinical features of patients with these tumors. In the absence of available data, it is difficult to identify characteristics of patients with potential PPGLs and normal serum and urine screens. Therefore, an analysis of patients with PPGLs was conducted retrospectively to compare the clinical features of patients with positive and negative catecholamines. This study included 214 patients, including 69 patients with negative catecholamines. Prevalence rates of diabetes (p < 0.001) and hypertension (p < 0.001) were lower and tumor diameter (p < 0.001) was smaller in the negative-catecholamine group compared with the positive-catecholamine group. Multivariable logistic regression analysis showed that extra-adrenal PPGLs were independently positively associated with negative catecholamines (p = 0.004); hypertension (p = 0.001) and tumor diameter (p = 0.016) were independently negatively associated with negative catecholamines. There was no significant difference in tumor recurrence between the two groups (mean follow-up, 20.54 ± 11.83 months) (p = 0.44). The results demonstrated that PPGL patients with negative catecholamines were more likely to have extra-adrenal tumors and less likely to have comorbidities, and these patients should also be closely monitored for tumor recurrence.

Arterial Hypertension Syndrome in Pheocromocytoma and Non-Functioning Adrenocortical Adenoma

“…отсутствовало повышение уровня мета-нефрина/норметанефрина. При ретроспективном сравнительном анализе пациентов с положительными и отрицательными результатами оказалось, что на отрицательный результат влияет вненадпочечниковое расположение опухоли, малые размеры опухоли, небольшая частота встречаемости АГ и гипергликемии [15]. В другом исследовании у 42 пациентов с инциденталомой надпочечников при отсутствии повышения метанефрина/норметанефрина в моче и крови у 14 чел.…”

Stable Lanthanide–Organic Frameworks: Crystal Structure, Photoluminescence, and Chemical Sensing of Vanillylmandelic Acid as a Biomarker of Pheochromocytoma

“…Pheochromocytoma (PCh) is a rare neuroendocrine tumor, which originates from human chromaffin cells of the adrenal cortex. − The common symptoms are tachycardia, hypertension, headache, anxiety, etc. − But there is a 20% probability of developing life-threatening hemodynamic instability, such as malignant arrhythmias, myocardial infarction, stroke, or sudden death. − If it is hormonally inactive, the presentation of PCh can be ambiguous and the interpretation of signs can be complicated even in advanced stages, which explains the delayed diagnosis . Vanillylmandelic acid (4-hydroxy-3-methoxymandelic acid, VMA) is the main terminal metabolite of adrenaline and norepinephrine in the human body. − The overmetabolism of adrenaline and norepinephrine is present in PCh patients, and they can be transformed in vivo to VMA and excreted with urine (1.0–2.9 × 10 –5 M in healthy people and a threefold increase in the pathological process of PHEO). , Thus, the urinary VMA can serve as a potential and easy biomarker for the early diagnosis and identification of PCh .…”