Epidemiologic Profile and Clinical Outcomes of Patients with Pheochromocytoma at the University of the Philippines - Philippine General Hospital (UP-PGH)
DOI:
https://doi.org/10.15605/jafes.039.02.18Keywords:
pheochromocytoma, clinical outcomes, recurrence, metastasisAbstract
Objective. This study aims to describe the epidemiologic profile and determine the clinical outcomes of patients with pheochromocytoma at the University of the Philippines Philippine General Hospital (UP-PGH).
Methodology. We reviewed the medical records of 30 patients with histopathology-proven, clinical, and biochemical diagnosis of pheochromocytoma. Demographic, clinical characteristics, and clinical outcomes were collected for each patient.
Results. The median age at diagnosis of pheochromocytoma was 37.5 years (IQR 28-55) and the most common metabolic comorbidities were glucose intolerance (60%) and hypertriglyceridemia (23.3%). Majority of the patients were hypertensive (90%). Two third of the patients presented with classic features of pheochromocytoma while the remaining third presented as adrenal incidentaloma. Recurrence was found in 17% of subjects, who were significantly younger (25 years vs 46.5 years P = 0.0229), and had higher rates of bilateral pheochromocytoma (0 vs 75%), p = 0.002). Metastatic pheochromocytoma was found in 10% of the subjects.
Conclusion. Our study demonstrated that patients with pheochromocytoma in our setting exhibit great variability in terms of clinical behavior. Although majority of the patients presented with symptoms related to catecholamine excess, almost one-third of the patients were only incidentally discovered. Incidence of pheochromocytoma recurrence and metastasis in our setting are comparable with current available foreign studies.
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Martucci VL, Pacak K. Pheochromocytoma and paraganglioma: diagnosis, genetics, management, and treatment. Curr Probl Cancer. 2014;38(1):7-41. https://pubmed.ncbi.nlm.nih.gov/24636754 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992879 https://doi.org/10.1016/j.currproblcancer.2014.01.001
Sohail S, Shafiq W, Raza SA, Zahid A, Mir K, Azmat U. Clinical characteristics and outcome of patients with pheochromocytoma: a single center tertiary care experience. Cureus. 2020;12(5):e7990. https://pubmed.ncbi.nlm.nih.gov/32523845 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274258 https://doi.org/10.7759/cureus.7990
Lenders JWM, Duh QY, Eisenhofer G, et al; Endocrine Society. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(6):1915-42. https://pubmed.ncbi.nlm.nih.gov/24893135 https://doi.org/10.1210/jc.2014-1498
Kopetschke R, Slisko M, Kilisli A, et al. Frequent incidental discovery of phaeochromocytoma: data from a German cohort of 201 phaeochromocytoma. Eur J Endocrinol. 2009;161(2):355-61. https://pubmed.ncbi.nlm.nih.gov/19497985 https://doi.org/10.1530/EJE-09-0384
Aggarwal S, Prete A, Chortis V, et al. Pheochromocytomas most commonly present as adrenal incidentalomas: a large tertiary center experience. J Clin Endocrinol Metab. 2023;109(1):e389-96. https://pubmed.ncbi.nlm.nih.gov/37417693 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735286 https://doi.org/10.1210/clinem/dgad401
Uslar T, San Francisco IF, Olmos R, et al. Clinical presentation and perioperative management of pheochromocytomas and paragangliomas: a 4-decade experience. J Endocr Soc. 2021;22;5(10):bvab073. https://pubmed.ncbi.nlm.nih.gov/34377881 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336720 https://doi.org/10.1210/jendso/bvab073
Plouin PF, Chatellier G, Fofol I, Corvol P. Tumor recurrence and hypertension persistence after successful pheochromocytoma operation. Hypertension. 1997;29(5):1133-9. https://pubmed.ncbi.nlm.nih.gov/9149678 https://doi.org/10.1161/01.hyp.29.5.1133
Beninato T, Kluijfhout WP, Drake FT, et al. Resection of pheochromocytoma improves diabetes mellitus in the majority of patients. Ann Surg Oncol. 2017;24(5):1208-13. https://pubmed.ncbi.nlm.nih.gov/27896511 https://doi.org/10.1245/s10434-016-5701-6
Kim JH, Moon H, Noh J, Lee J, Kim SG. Epidemiology and prognosis of pheochromocytoma/paraganglioma in Korea: a nationwide study based on the National Health Insurance Service. Endocrinol Metab (Seoul). 2020;35(1):157-64. https://pubmed.ncbi.nlm.nih.gov/32207276 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7090309 https://doi.org/10.3803/EnM.2020.35.1.157
Mesmar B, Poola-Kella S, Malek R. The physiology behind diabetes mellitus in patients with pheochromocytoma: a review of the literature. Endocr Pract. 2017;23(8):999-1005. https://pubmed.ncbi.nlm.nih.gov/28613940 https://doi.org/10.4158/EP171914.RA
van Heerden JA, Roland CF, Carney JA, Sheps SG, Grant CS. Long-term evaluation following resection of apparently benign pheochromocytoma(s)/paraganglioma(s). World J Surg. 1990;14(3):325-9. https://pubmed.ncbi.nlm.nih.gov/1973322 https://doi.org/10.1007/BF01658516
Parasiliti-Caprino M, Lucatello B, Lopez C, et al. Predictors of recurrence of pheochromocytoma and paraganglioma: a multicenter study in Piedmont, Italy. Hypertens Res. 2020;43(6):500-10. https://pubmed.ncbi.nlm.nih.gov/31586159 https://doi.org/10.1038/s41440-019-0339-y
Amar L, Fassnacht M, Gimenez-Roqueplo AP, et al. Long-term postoperative follow-up in patients with apparently benign pheochromocytoma and paraganglioma. Horm Metab Res. 2012;44(5):385-9. https://pubmed.ncbi.nlm.nih.gov/22351478 https://doi.org/10.1055/s-0031-1301339
Plouin PF, Amar L, Dekkers OM, et al. Guideline Working Group. European Society of Endocrinology Clinical Practice Guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma. Eur J Endocrinol. 2016;174(5):G1-10. https://pubmed.ncbi.nlm.nih.gov/27048283 https://doi.org/10.1530/EJE-16-0033
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