Potential pitfalls in the diagnosis of phaeochromocytoma.
Six patients being evaluated for phaeochromocytoma had misleading investigative findings: all initially had raised urinary catecholamine levels, and five had adrenal masses on imaging studies. Adrenalectomy in these five patients revealed only one pathologically confirmed phaeochromocytoma. Tricyclic antidepressant use produced misleading elevations in urinary catecholamine levels in three patients. 24-hour urine studies should be performed at least twice, after eliminating confounding factors (stressors, medications).
Harding
Jane L
JL
University of Sydney, Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, Australia.
Yeh
Michael W
MW
Robinson
Bruce G
BG
Delbridge
Leigh W
LW
Sidhu
Stan B
SB
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000601:surgery; D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects; D002395:Catecholamines / Q000652:urine*; D003951:Diagnostic Errors; D005189:False Positive Reactions; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000601:surgery; D013312:Stress, Physiological / Q000150:complications; D013927:Thrombosis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016482:Urinalysis / Q000379:methods
D000929:Antidepressive Agents, Tricyclic; D002395:Catecholamines