title: Gender-related differences in the clinical presentation of malignant and benign pheochromocytoma.
abstract: Signs and symptoms associated with pheochromocytomas are predominantly caused by catecholamine excess, but tend to be highly variable and non-specific. In this study, we evaluated 23 male and 35 female pheochromocytoma patients for symptoms and signs of pheochromocytoma with special regard to gender-related differences in presentation. Total symptom score comparison between genders showed significant differences (12.0 vs. 7.8, P-value 0.0001). Female patients reported significantly more headache (80% vs. 52%), dizziness (83% vs. 39%), anxiety (85% vs. 50%), tremor (64% vs. 33%), weight change (88% vs. 43%), numbness (57% vs. 24%), and changes in energy level (89% vs. 64%). Females and males displayed comparable biochemical phenotypes (60% and 65% noradrenergic phenotype, respectively). Use of alpha- and/or beta-blockade between males and females did not differ significantly. Subgroup analyses and multiple regression analysis revealed gender differences to be irrespective of benign or malignant disease, use of adrenoceptor-blockade, age and biochemical phenotype. We conclude female patients have significantly more self-reported pheochromocytoma signs and symptoms than male patients irrespective of biochemical phenotype and tumor presentation which may be related to distinct catecholamine receptor sensitivity. Clinicians should be aware of these complaints in female pheochromocytoma patients and offer adequate treatment if indicated.
authors.affiliation: Section on Medical Neuroendocrinology, Reproductive and Adult Endocrinology Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-1109, USA.
authors.forename: Edwin W
authors.initials: EW
authors.lastname: Lai
authors.forename: Shiromi M
authors.initials: SM
authors.lastname: Perera
authors.forename: Bas
authors.initials: B
authors.lastname: Havekes
authors.forename: Henri J L M
authors.initials: HJ
authors.lastname: Timmers
authors.forename: Frederieke M
authors.initials: FM
authors.lastname: Brouwers
authors.forename: Beverly
authors.initials: B
authors.lastname: McElroy
authors.forename: Karen T
authors.initials: KT
authors.lastname: Adams
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Ohta
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wesley
authors.forename: Graeme
authors.initials: G
authors.lastname: Eisenhofer
authors.forename: Karel
authors.initials: K
authors.lastname: Pacak
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D010641:Phenotype; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D013546:Sweating / Q000502:physiology; D013610:Tachycardia / Q000209:etiology; D015431:Weight Loss / Q000502:physiology
chemical_list: D015415:Biomarkers