Percutaneous biopsy of adrenal and extra-adrenal retroperitoneal lesions: beware of catecholamine secreting tumours!
BACKGROUND
Many patients undergo abdominal imaging for non-specific symptoms. An increasing number of these patients are discovered to have incidental adrenal or retroperitoneal tumours. Approximately 5% of all incidentally detected adrenal lesions are phaeochromocytomas and 25% of phaeochromocytomas are discovered during imaging studies for unrelated disorders. 10% of phaeochromocytomas are extra-adrenal.


METHODS
Retrospective case notes review of three patients with adrenal/retroperitoneal lesions who had percutaneous biopsy before biochemical testing and tertiary referral.


RESULTS
Adrenal/retroperitoneal lesions are still being biopsied without prior biochemical testing. One patient with phaeochromocytoma had a critical event. The others were found to have a phaeochromocytoma and a ganglioneuroma.


CONCLUSIONS
The possibility of a catecholamine secreting tumour should be considered in adrenal and extra-adrenal retroperitoneal lesions. If a biopsy is planned, rarely required in adrenal lesions, phaeochromocytoma must be excluded by biochemical testing prior to the biopsy to avoid potential life threatening complications.
Sood
S K
SK
Unit of Surgical Oncology, University of Sheffield, Sheffield.
Balasubramanian
S P
SP
Harrison
B J
BJ
D000310:Adrenal Gland Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D001706:Biopsy; D002395:Catecholamines / Q000378:metabolism; D005260:Female; D005729:Ganglioneuroma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D012186:Retroperitoneal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
D002395:Catecholamines