title: Isolated adrenal mass in patients with a history of cancer: remember pheochromocytoma.
abstract: BACKGROUND
  In a patient with a history of cancer, an isolated adrenal mass is usually thought to be a metastasis. Although a biochemical work-up to rule out pheochromocytoma is recommended, some question its practicality. This study was undertaken to determine the incidence of functional adrenal lesions in patients with a history of cancer and examine predictive factors for the type of lesion.
  
  
  METHODS
  At a single institution, 33 patients with an isolated adrenal mass and a history of cancer underwent surgical treatment. Patients' records were retrospectively analyzed for type of adrenal lesion and other diagnostic parameters.
  
  
  RESULTS
  There were 20 males and 13 females with a mean age of 58+/-2 years. Of these, 20 (61%) had adrenal metastases, 8 (24%) had pheochromocytomas, and 5 (15%) had adrenal adenomas. Usual diagnostic criteria, including presenting symptoms, primary tumor, and other demographic characteristics, did not consistently predict the pathology of the lesion.
  
  
  CONCLUSIONS
  Nearly 1 in 4 resected adrenal masses in patients with a history of cancer were pheochromocytomas. The high incidence of pheochromocytoma in this series supports a thorough work-up, irrespective of previous cancer. Therefore, remember one thing in patients with an isolated adrenal mass and a history of cancer: pheochromocytoma.
authors.affiliation: Department of Surgery, Section of Endocrine Surgery, H4/750 Clinical Science Center, 600 Highland Avenue, University of Wisconsin, Madison, WI 53792, USA.
authors.forename: Joel T
authors.initials: JT
authors.lastname: Adler
authors.forename: Eberhard
authors.initials: E
authors.lastname: Mack
authors.forename: Herbert
authors.initials: H
authors.lastname: Chen
mesh_terms: D000236:Adenoma / Q000473:pathology; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D000315:Adrenalectomy; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000473:pathology; D010673:Pheochromocytoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D049268:Positron-Emission Tomography; D011859:Radiography; D012189:Retrospective Studies; D047368:Tumor Burden