[Significance of CT findings and catecholamine determination in peripheral blood of asymptomatic pheochromocytoma and paraganglioma].
The purpose of this study was to assess the CT findings and significance of hormone determination in the peripheral blood of asymptomatic patients with pheochromocytoma and paraganglioma. CT findings in 29 patients with surgically proven pheochromocytoma(n = 19) and paraganglioma(n = 10) were reviewed. Nine patients(31%) were symptomatic and 20 (69%) were asymptomatic. Tumor size ranged from 39 mm to 114 mm(mean: 60 mm) in symptomatic patients and 11 mm to 100 mm(mean: 50 mm) in asymptomatic ones. Of the 9 symptomatic patients and 18 asymptomatic patients, a homogeneous solid pattern was seen in 4 and 4, mixed pattern in 2 and 6, and massive necrotic pattern in 3 and 8 patients, respectively, on CT scans. The CT attenuation values in symptomatic cases ranged from 30 HU to 50 HU(mean: 41 HU) on precontrast CT scans and 60 HU to 111 HU(mean: 77 HU) on postcontrast CT scans, while those in asymptomatic cases ranged from 15 HU to 48 HU(mean: 33 HU) on precontrast CT scans and 66 HU to 133 HU(mean: 95 HU) on postcontrast CT scans. There were no statistically significant differences in tumor size, homogeneity, or CT attenuation values between symptomatic and asymptomatic patients. All symptomatic patients and 17(89%) of 19 asymptomatic cases showed elevated levels of catecholamine (epinephrine) or norepinephrine in the peripheral blood. Our study showed that the CT findings in asymptomatic patients were similar to those in symptomatic patients, and 89% of asymptomatic patients showed elevation of catecholamine in the peripheral blood. Determination of catecholamine level in the peripheral blood is recommended for preoperative diagnosis in patients suspected of having asymptomatic pheochromocytoma or paraganglioma on CT scans.
Saginoya
T
T
Department of Radiology, Oita Medical University.
Miyake
H
H
Kiyosue
H
H
Okahara
M
M
Hori
Y
Y
Hata
H
H
Mori
H
H
D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D002395:Catecholamines / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000097:blood / Q000000981:diagnostic imaging*; D010673:Pheochromocytoma / Q000097:blood / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
D002395:Catecholamines