National Cancer Institute®
Ultima Vez Modificado: 1 de agosto del 2002
UI - 11939762
AU - Sleilati GG; Kovacs KT; Honasoge M
TI - Acromegaly and pheochromocytoma: report of a rare coexistence.
SO - Endocr Pract 2002 Jan-Feb;8(1):54-60
AD - Department of Endocrinology and Metabolism, Henry Ford Health System, Detroit, Michigan 48202, USA.
OBJECTIVE: To describe a patient with the rare coexistence of acromegaly and pheochromocytoma. METHODS: We report a case of a 57-year-old woman, who was initially examined because of polyarthritis, she was also diagnosed with type 2 diabetes mellitus and hypertension at age 56 years. Her history, clinical findings, laboratory results, and management are summarized, and etiologic hypotheses are discussed. RESULTS: The patient had recurrent headaches and reported an increasing size of her shoes and gloves during the previous 4 years. Enlargement of her hands and feet and a bilateral temporal field defect were noted on examination. Laboratory studies revealed high levels of insulin-like growth factor I (IGF-I) and growth hormone (GH). Magnetic resonance imaging (MRI) showed a 3-cm sellar mass with impingement on the optic chiasm. The plasma level of growth hormone-releasing hormone (GHRH) was normal. She underwent transsphenoidal adenomectomy. Histologic examination confirmed a pituitary adenoma, immunoreactive for GH. Postoperatively, her headaches and arthritic pain diminished, and her levels of IGF-I and GH normalized; however, labile hypertension persisted. The urinary metanephrines and plasma catecholamines were increased. A 3-cm left adrenal mass, seen on abdominal MRI, was removed laparoscopically, after which urinary metanephrines normalized and both the diabetes and the hypertension resolved. Histopathologic analysis confirmed the diagnosis of pheochromocytoma. Immunohistochemical staining was negative for GHRH. CONCLUSION: The finding of a pheochromocytoma and acromegaly could be a fortuitous coexistence of two separate endocrine tumors; however, the probability of such an event is extremely low. A cause-and-effect relationship has been suggested because of previous reports of GHRH production by pheochromocytomas. Some investigators have also suggested that this coexistence might be a multiple endocrine neoplasia variant. Our patient had no evidence of GHRH production, nor did we document any familial autosomal dominant transmission pattern.
UI - 11954548
AU - Stanciu IN; Sizemore GW; DeJong SA; Camacho PM
TI - A case presentation. Metastatic pheochromocytoma.
SO - Endocr Pract 2002 Mar-Apr;8(2):138-9
AD - Division of Endocrinology and Metabolism, Loyola University Chicago Medical Center, Maywood, Illinois, USA.
UI - 11893039
AU - Jorda M; De MB; Nadji M
TI - Calretinin and inhibin are useful in separating adrenocortical neoplasms from pheochromocytomas.
SO - Appl Immunohistochem Mol Morphol 2002 Mar;10(1):67-70
AD - Department of Pathology, University of Miami/Jackson Memorial Medical Center, Florida 33136, USA. firstname.lastname@example.org
Most adrenocortical neoplasms and pheochromocytomas can be diagnosed by a combination of clinical findings and morphologic features. Occasionally, however, this histologic differential diagnosis requires ancillary tests, such as immunohistochemistry. Both tumors are generally negative for epithelial markers but express synaptophysin. Inhibin and chromogranin are used for the diagnosis of adrenocortical neoplasms and pheochromocytomas, respectively. Both antigens, however, are expressed focally and may be completely negative, particularly in small biopsies. The authors investigated the potential value of adding calretinin to inhibin in the differential diagnosis of these tumors. Fifty-five primary adrenal neoplasms including 33 adrenocortical tumors (21 adenomas and 12 carcinomas), 22 pheochromocytomas, and 7 healthy adrenal glands were examined immunohistochemically for the expression of calretinin and inhibin. Inhibin was demonstrated in 24 (73%) adrenocortical neoplasms. When calretinin was added, the number of tumors staining positively for the two markers alone or in combination increased to 31 (94%). Both antigens showed a focal pattern of distribution in many cases. None of the pheochromocytomas reacted for any of these two markers. Healthy adrenal gland showed a distinct positive and negative pattern of immunoreactivity for both antigens in cortex and medulla, respectively. There were no differences between staining patterns of calretinin and inhibin in healthy adrenal cortex, adrenocortical adenomas, and adrenocortical carcinomas. The authors conclude that the addition of calretinin to inhibin increases the sensitivity of the diagnosis of adrenocortical neoplasms. When used together, they are highly specific and sensitive for the differential diagnosis of these tumors from pheochromocytomas. These markers, however, do not distinguish between benign and malignant adrenocortical neoplasms.
UI - 12088924
AU - van der Harst E; de Herder WW; de Krijger RR; Bruining HA; Bonjer HJ;
TI - Lamberts SW; van den Meiracker AH; Stijnen TH; Boomsma F The value of plasma markers for the clinical behaviour of phaeochromocytomas.
SO - Eur J Endocrinol 2002 Jul;147(1):85-94
AD - Department of Surgery, Erasmus University Hospital and MCRZ location Clara, Rotterdam, The Netherlands. harstE@mcrz.nl
OBJECTIVE: Phaeochromocytomas (PCCs) are widely known for their clinical unpredictability. This study intends to define predictive plasma markers for their variable postoperative behaviour. Furthermore, the diagnostic accuracy of these plasma tests was determined. DESIGN AND METHODS: A retrospective correlative study was performed in a series of 83 operated and four autopsied patients in order to correlate preoperative catecholamine (CAT) levels of 103 PCCs with their clinical behaviour. In a subset of cases, chromogranin-A (Chr-A) and enzymes/precursors of the CAT biosynthesis were studied for their predictive value. RESULTS: Basal CAT levels were elevated in 81/87 instances (sensitivity: 93%). Four of six cases with normal measurements showed only medullary hyperplasia. Larger PCCs, particularly those showing necrosis, capsular and vascular invasion, secreted higher CAT levels. Bilateral, hereditary tumours were less productive than their unilateral counterparts. Extra-adrenal PCCs secreted significantly lower levels of epinephrine (EPI) than intra-adrenal tumours. Fourteen patients developed metastases. According to Kaplan-Meier estimations, patients with higher levels of dopamine, norepinephrine (NE) and aromatic l-amino acid decarboxylase as well as lower ratios of EPI/EPI+NE, had significantly shorter metastases-free intervals. Existence of preoperative hypertension, left ventricular hypertrophy and measured blood pressures showed significant positive relationships with CAT levels, but not with Chr-A. CONCLUSIONS: These data showed that plasma CAT measurement is a sensitive method in the diagnostic work-up of PCCs. Those tumours producing normal levels are commonly small and asymptomatic. Furthermore, certain secretion patterns are indicative of the presence of metastases as well as the size and site of sporadic and syndrome-related PCCs.
UI - 12134591
AU - Tauzin-Fin P; Krol-Houdek MC; Gosse P; Ballanger P
TI - [Laparoscopic adrenalectomy for pheochromocytoma. Perioperative blockade with urapidil]
SO - Ann Fr Anesth Reanim 2002 Jun;21(6):464-70
AD - Departement d'anesthesie-reanimation III, hopital Pellegrin-Tondu, 5, place Amelie Raba-Leon, 33076 Bordeaux, France. email@example.com
OBJECTIVE: To investigate the effects of coeliosurgery by catecholamine assays and the use of urapidil in the management of phaeochromocytoma. STUDY DESIGN: Prospective cohort study. PATIENTS: Nine consecutive was administered by continuous intravenous infusion three days before surgery and continued throughout anaesthesia. Plasma catecholamine concentrations were measured before surgery, after induction of anaesthesia, during insufflation, after adrenalectomy and in the recovery room. Haemodynamic disorders were treated by nicardipine +/- esmolol bolus doses. RESULTS: Creation of pneumoperitoneum and adrenal gland manipulations resulted in significant catecholamine releases associated with hypertension in five and eight patients respectively. Preventive urapidil use enabled easy control of blood pressure variations by additive antihypertensive drugs. CONCLUSION: Perioperative alpha 1 blockade by urapidil enables an effective and easy control of acute preoperative haemodynamic changes.
UI - 12069476
AU - Rocher L; Youssef N; Tasu JP; Paradis V; Blery M
TI - Adrenal pheochromocytoma and controlateral myelolipoma.
SO - Clin Radiol 2002 Jun;57(6):535-7
AD - Department of Radiology, Bicetre Hospital, Le Kremlin Bicetre, France. firstname.lastname@example.org.-hop-paris.fr
UI - 12056028
AU - Ichikawa H; Sugano H; Tanada S; Sawada T; Nakayama K; Yorimitsu S;
TI - Takahashi I; Iwata J [Diabetes mellitus with mixed neuroendocrine-neural tumor]
SO - Nippon Naika Gakkai Zasshi 2002 Apr 10;91(4):1309-12
AD - Department of Internal Medicine, Kochi Municipal Central Hospital, Kochi.
UI - 12082751
AU - Ishiguro A; Hirai Y; Hasegawa N; Nakamura J; Tamura M; Nishimura S;
TI - Kaimori M; Sasano H [WDHA syndrome by composite pheochromocytoma and ganglioneuroma]
SO - Nippon Naika Gakkai Zasshi 2002 May 10;91(5):1585-8
AD - Department of Endocrinology, Aomori Prefecture Central Hospital.
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