[Clinical manifestation and multiphasic spiral CT scanning features of abdominal pheochromocytoma: report of 70 cases].
OBJECTIVE
The purpose of this study was to assess the imaging characteristics of abdominal pheochromocytoma in multiphasic spiral CT scanning, and to determine whether these image characteristics can aid in differentiating pheochromocytoma from other types of tumors or not.


METHODS
The image data of dynamic enhanced CT of 79 pathologically confirmed pheochromocytomas in 70 patients were retrospectively reviewed.


RESULTS
Among the 70 patients, there were 41 patients with endocrine symptoms related to pheochromocytoma, 15 had a latent pheochromocytoma and the remaining 14 cases presented with a non-functioning pheochromocytoma. There were totally 79 tumors in 70 patients, with a single lesion in 63 cases, while multiple lesions in the other 7. Sixty cases had a tumor located in the adrenal gland, while 8 in retroperitoneal space, and 2 cases had both intraadrenal and ectopic lesions simultaneously. Sixty patients had a benign pheochromocytoma, the other 10 had a malignant one or relapse after operation. The average size of the tumor was 5.8 cm (range, 2 approximately 15 cm in the longest diameter). Seventy-seven pheochromocytomas had a well defined boundary except two big ones with a unclear margin, which were finally proven to be malignant. Homogeneous enhancement was found in 6 lesions with a diameter <or= 4 cm. Blood sinuses were found in 25 lesions. Hemorrhage, necrosis and cystic change were detected in 48 lesions, with fluid-fluid levels in nine of these lesions. Rich blood supply was found in 65 lesions and moderate in 14.


CONCLUSIONS
Approximately half of the abdominal pheochromocytomas are lack of endocrine symptoms related with their tumors. However, they may display some typical CT characteristics, such as that a small lesion is often homogeneous but hypervascular, a larger tumor may present hemorrhage, necrosis, and cystic change with rich or moderate blood supply. However, when a small tumor has moderate blood supply, it should be differentiated with an adrenal adenoma; when a big one has moderate blood supply, it should be differentiated with other malignant tumors. Furthermore, a part of malignant pheochromocytomas is really difficult to be differentiated from some benign lesions by spiral CT images alone.
Han
Xi-nian
XN
Department of Diagnostic Radiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. hanxinian@163.com
Chen
Biao
B
Ye
Xiao-dan
XD
Wang
Jian
J
Liu
Guang-hua
GH
D000236:Adenoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010673:Pheochromocytoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery; D011856:Radiographic Image Enhancement; D012186:Retroperitoneal Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*; D055815:Young Adult