American Association of Endocrine SurgeonShould pheochromocytoma size influence surgical approach? A comparison of 90 malignant and 60 benign pheochromocytomas
Section snippets
Methods
The SEER database is a comprehensive source of information regarding cancer incidence and survival in the United States. The information in the SEER database is accrued from several regional cancer registries and includes demographics, tumor characteristics, treatment, and survival for more than 3 million patients between 1973 and 2000. We reviewed the SEER database13 for patients who were treated for malignant pheochromocytoma. Size data for tumors in the SEER database have only been collected
Results
We identified 90 malignant pheochromocytomas in the SEER database treated between 1988 and 2000. From the UCSF database, we identified 56 patients with 60 benign pheochromocytomas who underwent adrenalectomy between 1993 and 2003. Follow-up time was 50 ± 42 months for the SEER group. Mean time from surgery was 62 ± 31 months for the UCSF group; all of the UCSF patients are seen by their surgeon within 1 month of operation and are then followed closely by our referring primary care physicians
Discussion
When signs of regional involvement or distant disease are absent, there is currently no reliable preoperative diagnostic test that can differentiate between malignant and benign pheochromocytomas. Because pheochromocytomas are rare, and malignant pheochromocytomas represent only 2.4% to 26% of these already uncommon tumors,4., 5., 6., 7., 8. few centers have accumulated enough patients to produce accurate and generalizable information regarding malignant pheochromocytomas. We therefore used the
Addendum
Before publication of this article we were informed by a referring physician that 1 patient in the benign pheochromocytoma database had developed local recurrence at the resection site as well as pulmonary metastases. This individual is currently undergoing 131-I MIBG treatment under an investigational protocol. The primary tumor was a 9-cm, right adrenal pheochromocytoma, and the operation was converted from laparoscopic to open adrenalectomy because of tumor adhesions to the liver. This new
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Outcomes of malignant pheochromocytoma based on operative approach: A National Cancer Database analysis
2021, Surgery (United States)Citation Excerpt :Pheochromocytoma is diagnosed with a combination of typical symptomatology, biochemical testing, and imaging.1,4 Reports have levied large tumor size as a marker of malignant nature, although this is not widely accepted.13,21 Other than visualizing the presence of local invasion or distant metastatic disease on preoperative imaging, designating a pheochromocytoma as malignant before adrenalectomy remains difficult.
French ccAFU guidelines - update 2020-2022: malignancy assessment of an adrenal incidentaloma
2020, Progres en UrologieFrench ccAFU guidelines – Update 2018–2020: Adrenal cancer
2018, Progres en Urologie
Presented at the 25th Annual Meeting of the American Association of Endocrine Surgeons, Charlottesville, Virginia, April 4-6, 2004.
Supported in part by the Robert Wood Johnson/Harold Amos Faculty Development Program Fellowship, the Hellman Family Grant, the Albert Clark Family Foundation, the Sanford and Helen Diller Foundation, Friends of Endocrine Surgery, and the Mt. Zion Health Systems.