title: Recurrence of Phaeochromocytoma and Abdominal Paraganglioma After Initial Surgical Intervention.
abstract: BACKGROUND
  Clinical and biochemical follow up after surgery for phaeochromocytoma is essential with long term studies demonstrating recurrence frequencies between 6% and 23%.
  
  
  OBJECTIVE
  To examine the characteristics and frequency of tumour recurrence in a regional endocrine referral centre, in patients with surgical resection of phaeochromocytoma (P) and abdominal paraganglioma (AP).
  
  
  METHODS
  We identified a cohort of 52 consecutive patients who attended our Regional Endocrinology & Diabetes Centre and retrospectively reviewed their clinical, biochemical and radiological data (between 2002 and 2013). After confirmation of early post-operative remission by negative biochemical testing, tumour recurrence was defined by demonstration of catecholamine excess with confirmatory imaging.
  
  
  RESULTS
  Phaeochromocytoma was confirmed histologically in all cases (43:P, 9:AP, mean-age:53 years). Open adrenalectomy was performed in 20 cases and laparoscopically in 32. Hereditary phaeochromocytoma was confirmed by genetic analysis in 12 (23%) patients. Median follow up time from initial surgery was 47 months, (range: 12 - 296 months), 49 patients had no evidence of tumour recurrence at latest follow-up. Three patients (6%) demonstrated tumour development, one in a patient with VHL which occurred in a contralateral adrenal gland, one sporadic case had local recurrence, and an adrenal tumour occurred in a patient with a SDHB gene mutation who had a previous bladder tumour. After initial surgery, the tumours occurred at 8.6, 12.0 and 17.7 years respectively.
  
  
  CONCLUSIONS
  In this study tumour development occurred in 6% of patients. Although tumour rates were low, careful and sustained clinical and biochemical follow up is advocated, as new tumour development or recurrence may occur long after the initial surgery is performed.
authors.affiliation: Regional Centre for Endocrinology and Diabetes.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Johnston
authors.affiliation: Regional Centre for Endocrinology and Diabetes.
authors.forename: Karen R
authors.initials: KR
authors.lastname: Mullan
authors.affiliation: Regional Centre for Endocrinology and Diabetes.
authors.forename: A Brew
authors.initials: AB
authors.lastname: Atkinson
authors.affiliation: Department of Endocrine Surgery.
authors.forename: Fiona C
authors.initials: FC
authors.lastname: Eatock
authors.affiliation: Regional Centre for Endocrinology and Diabetes.
authors.forename: Helen
authors.initials: H
authors.lastname: Wallace
authors.affiliation: Department of Pathology, Royal Victoria Hospital, Belfast, UK.
authors.forename: Moyra
authors.initials: M
authors.lastname: Gray
authors.affiliation: Regional Centre for Endocrinology and Diabetes.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Hunter
mesh_terms: D000008:Abdominal Neoplasms / Q000601:surgery*; D000310:Adrenal Gland Neoplasms / Q000235:genetics / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010236:Paraganglioma, Extra-Adrenal / Q000601:surgery*; D010673:Pheochromocytoma / Q000235:genetics / Q000601:surgery*; D055815:Young Adult
keywords: abdominal paraganglioma; long term follow up; phaeochromocytoma; tumour recurrence