EPIDEMIOLOGIC PROFILE AND CLINICAL OUTCOMES OF PATIENTS WITH PHEOCHROMOCYTOMA AT THE PHILIPPINE GENERAL HOSPITAL

Abstract

OBJECTIVES

Pheochromocytomas are rare catecholamine-secreting neuroendocrine tumors. They exhibit great variability in terms of clinical behavior which makes it challenging to diagnose. This study aims to describe the epidemiologic profile and to determine the clinical outcomes of patients with pheochromocytoma at the Philippine General Hospital.

METHODOLOGY

We reviewed the medical records of 30 adult patients with clinical, biochemical and histopathologic-proven diagnosis of pheochromocytoma from January 2010 to December 2021. Demographic, clinical characteristics and clinical outcomes were collected. Outcome measures included clinical and/ or biochemical remission, recurrence and metastasis.

RESULTS

The median age at diagnosis of pheochromocytoma was 37.5 years (IQR 28-55).The most common metabolic comorbidities detected were glucose intolerance (60%) and hypertriglyceridemia (23.3%). Majority of the patients were hypertensive (90%) on diagnosis. Two-thirds of patients presented with classic features of pheochromocytoma while the remaining third presented with adrenal incidentalomas. Recurrence was found in 17% of subjects, where in those with younger age of presentation (25 years vs 46.5 years, p=0.0229) and bilateral pheochromocytoma (0 vs 75%, p=0.002) had higher likelihood of recurrence. Metastatic pheochromocytoma was found in 10% of the subjects in our institution.

CONCLUSION

Although majority of the patients presented with symptoms related with catecholamine excess, almost one third of the patients had incidental discovery. Incidence of pheo- chromocytoma recurrence and metastasis in our setting has been shown to be comparable with current available studies. This study has demonstrated a low rate of genetic testing likely due to limited access to the test in our setting.