Serendipity in the diagnosis of pheochromocytoma

Alexander Roman Oshmyansky, Abdelkader Mahammedi, Alan Dackiw, Douglas W. Ball, Richard D. Schulick, Martha A. Zeiger, Stanley S. Siegelman

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVES: Pheochromocytomas are increasingly being discovered incidentally on imaging studies performed without clinical suspicion of the existence of an adrenal lesion. We aimed to determine the rate of diagnosis of adrenal pheochromocytoma as an incidental finding during a recent 7-year period. METHODS: We obtained the Department of Pathology database to study all the patients at our institution with newly diagnosed pheochromocytomas in the 7-year period from 2005 to 2011 to determine the clinical presentation and the means of diagnosis. RESULTS: In 40 (70.2%) of the 57 patients, an adrenal pheochromocytoma was detected in an imaging study performed without suspicion of an adrenal lesion. There were 13 chest computed tomography studies-8 to evaluate for possible pulmonary emboli. Other indications included abdominal pain or discomfort (n = 8), trauma (n = 3), abnormal liver function tests (n = 3), suspect renal artery stenosis (n = 3), hematuria (n = 2), colitis (n = 2), and 4 miscellaneous indications. DISCUSSION: Our study documents that the commonest current means of initial detection of pheochromocytoma is by serendipitous discovery. In 16 of our 40 patients with serendipitously discovered pheochromocytomas, there were no clinical symptoms of pheochromocytoma; these were true incidentalomas. More than two thirds of the new cases of pheochromocytoma were detected by serendipity (found during studies not performed to evaluate for pheochromocytoma), approximately one third were true incidentalomas (pheochromocytomas in patients without symptoms). CONCLUSIONS: In a 7-year period at a single institution, 40 patients, 70% of new cases of surgically proven pheochromocytoma, were initially detected by serendipity. Sixteen patients, 40% of those incidentally discovered represented true examples of "incidentalomas."

Original languageEnglish (US)
Pages (from-to)820-823
Number of pages4
JournalJournal of Computer Assisted Tomography
Volume37
Issue number5
DOIs
StatePublished - Sep 2013

Fingerprint

Pheochromocytoma
Renal Artery Obstruction
Incidental Findings
Liver Function Tests
Hematuria
Colitis
Embolism
Abdominal Pain
Thorax
Tomography
Databases
Pathology
Lung

Keywords

  • adrenal
  • CT
  • incidentaloma
  • pheochromocytoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Oshmyansky, A. R., Mahammedi, A., Dackiw, A., Ball, D. W., Schulick, R. D., Zeiger, M. A., & Siegelman, S. S. (2013). Serendipity in the diagnosis of pheochromocytoma. Journal of Computer Assisted Tomography, 37(5), 820-823. https://doi.org/10.1097/RCT.0b013e31829cbecf

Serendipity in the diagnosis of pheochromocytoma. / Oshmyansky, Alexander Roman; Mahammedi, Abdelkader; Dackiw, Alan; Ball, Douglas W.; Schulick, Richard D.; Zeiger, Martha A.; Siegelman, Stanley S.

In: Journal of Computer Assisted Tomography, Vol. 37, No. 5, 09.2013, p. 820-823.

Research output: Contribution to journalArticle

Oshmyansky, AR, Mahammedi, A, Dackiw, A, Ball, DW, Schulick, RD, Zeiger, MA & Siegelman, SS 2013, 'Serendipity in the diagnosis of pheochromocytoma', Journal of Computer Assisted Tomography, vol. 37, no. 5, pp. 820-823. https://doi.org/10.1097/RCT.0b013e31829cbecf
Oshmyansky AR, Mahammedi A, Dackiw A, Ball DW, Schulick RD, Zeiger MA et al. Serendipity in the diagnosis of pheochromocytoma. Journal of Computer Assisted Tomography. 2013 Sep;37(5):820-823. https://doi.org/10.1097/RCT.0b013e31829cbecf
Oshmyansky, Alexander Roman ; Mahammedi, Abdelkader ; Dackiw, Alan ; Ball, Douglas W. ; Schulick, Richard D. ; Zeiger, Martha A. ; Siegelman, Stanley S. / Serendipity in the diagnosis of pheochromocytoma. In: Journal of Computer Assisted Tomography. 2013 ; Vol. 37, No. 5. pp. 820-823.
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abstract = "OBJECTIVES: Pheochromocytomas are increasingly being discovered incidentally on imaging studies performed without clinical suspicion of the existence of an adrenal lesion. We aimed to determine the rate of diagnosis of adrenal pheochromocytoma as an incidental finding during a recent 7-year period. METHODS: We obtained the Department of Pathology database to study all the patients at our institution with newly diagnosed pheochromocytomas in the 7-year period from 2005 to 2011 to determine the clinical presentation and the means of diagnosis. RESULTS: In 40 (70.2{\%}) of the 57 patients, an adrenal pheochromocytoma was detected in an imaging study performed without suspicion of an adrenal lesion. There were 13 chest computed tomography studies-8 to evaluate for possible pulmonary emboli. Other indications included abdominal pain or discomfort (n = 8), trauma (n = 3), abnormal liver function tests (n = 3), suspect renal artery stenosis (n = 3), hematuria (n = 2), colitis (n = 2), and 4 miscellaneous indications. DISCUSSION: Our study documents that the commonest current means of initial detection of pheochromocytoma is by serendipitous discovery. In 16 of our 40 patients with serendipitously discovered pheochromocytomas, there were no clinical symptoms of pheochromocytoma; these were true incidentalomas. More than two thirds of the new cases of pheochromocytoma were detected by serendipity (found during studies not performed to evaluate for pheochromocytoma), approximately one third were true incidentalomas (pheochromocytomas in patients without symptoms). CONCLUSIONS: In a 7-year period at a single institution, 40 patients, 70{\%} of new cases of surgically proven pheochromocytoma, were initially detected by serendipity. Sixteen patients, 40{\%} of those incidentally discovered represented true examples of {"}incidentalomas.{"}",
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AB - OBJECTIVES: Pheochromocytomas are increasingly being discovered incidentally on imaging studies performed without clinical suspicion of the existence of an adrenal lesion. We aimed to determine the rate of diagnosis of adrenal pheochromocytoma as an incidental finding during a recent 7-year period. METHODS: We obtained the Department of Pathology database to study all the patients at our institution with newly diagnosed pheochromocytomas in the 7-year period from 2005 to 2011 to determine the clinical presentation and the means of diagnosis. RESULTS: In 40 (70.2%) of the 57 patients, an adrenal pheochromocytoma was detected in an imaging study performed without suspicion of an adrenal lesion. There were 13 chest computed tomography studies-8 to evaluate for possible pulmonary emboli. Other indications included abdominal pain or discomfort (n = 8), trauma (n = 3), abnormal liver function tests (n = 3), suspect renal artery stenosis (n = 3), hematuria (n = 2), colitis (n = 2), and 4 miscellaneous indications. DISCUSSION: Our study documents that the commonest current means of initial detection of pheochromocytoma is by serendipitous discovery. In 16 of our 40 patients with serendipitously discovered pheochromocytomas, there were no clinical symptoms of pheochromocytoma; these were true incidentalomas. More than two thirds of the new cases of pheochromocytoma were detected by serendipity (found during studies not performed to evaluate for pheochromocytoma), approximately one third were true incidentalomas (pheochromocytomas in patients without symptoms). CONCLUSIONS: In a 7-year period at a single institution, 40 patients, 70% of new cases of surgically proven pheochromocytoma, were initially detected by serendipity. Sixteen patients, 40% of those incidentally discovered represented true examples of "incidentalomas."

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