TY  - JOUR
A1  - Rogowski-Lehmann, Natalie
A1  - Geroula, Aikaterini
A1  - Prejbisz, Aleksander
A1  - Timmers, Henri J. L. M.
A1  - Megerle, Felix
A1  - Robledo, Mercedes
A1  - Fassnacht, Martin
A1  - Fliedner, Stephanie M. J.
A1  - Reincke, Martin
A1  - Stell, Anthony
A1  - Januszewicz, Andrzej
A1  - Lenders, Jacques W. M.
A1  - Eisenhofer, Graeme
A1  - Beuschlein, Felix
T1  - Missed clinical clues in patients with pheochromocytoma/paraganglioma discovered by imaging
JF  - Endocrine Connections
N2  - Background: Pheochromocytomas and paragangliomas (PPGLs) are rare but potentially harmful tumors that can vary in their clinical presentation. Tumors may be found due to signs and symptoms, as part of a hereditary syndrome or following an imaging procedure. Objective: To investigate potential differences in clinical presentation between PPGLs discovered by imaging (iPPGLs), symptomatic cases (sPPGLs) and those diagnosed during follow-up because of earlier disease/known hereditary mutations (fPPGL). Design: Prospective study protocol, which has enrolled patients from six European centers with confirmed PPGLs. Data were analyzed from 235 patients (37 iPPGLs, 36 sPPGLs, 27% fPPGLs) and compared for tumor volume, biochemical profile, mutation status, presence of metastases and self-reported symptoms. iPPGL patients were diagnosed at a significantly higher age than fPPGLs (P<0.001), found to have larger tumors (P=0.003) and higher metanephrine and normetanephrine levels at diagnosis (P=0.021). Significantly lower than in sPPGL, there was a relevant number of self-reported symptoms in iPPGL (2.9 vs 4.3 symptoms, P< 0.001). In 16.2% of iPPGL, mutations in susceptibility genes were detected, although this proportion was lower than that in fPPGL (60.9%) and sPPGL (21.5%). Patients with PPGLs detected by imaging were older, have higher tumor volume and more excessive hormonal secretion in comparison to those found as part of a surveillance program. Presence of typical symptoms indicates that in a relevant proportion of those patients, the PPGL diagnosis had been delayed. Precis: Pheochromocytoma/paraganglioma discovered by imaging are often symptomatic and carry a significant proportion of germline mutations in susceptibility genes.
KW  - pheochromocytoma
KW  - paraganglioma
KW  - imaging
KW  - signs and symptoms
KW  - prospective
KW  - Biochemical-Diagnosis
KW  - Plasma
KW  - MASS
KW  - Normetanephrine
KW  - Metanephrine
KW  - Paraganglioma
KW  - Society
KW  - Utility
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226481
VL  - 7
IS  - 11
ER  -