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Horm Metab Res 2015; 47(09): 633-636
DOI: 10.1055/s-0035-1555900
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Biochemical Testing After Pheochromocytoma Removal: How Early?

T. Zelinka
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
O. Petrák
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
B. Hamplová
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
H. Turková
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
2   Department of Oncology, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
,
P. Waldauf
3   Department of Anesthesiology and Critical Care Medicine, Third Faculty of Medicine, Charles University and Hospital Královské Vinohrady, Prague, Czech Republic
,
J. Rosa
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
Z. Šomlóová
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
R. Holaj
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
B. Štrauch
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
T. Indra
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
M. Kršek
4   3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
A. Brabcová Vránková
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
5   Institute of Clinical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
Z. Musil
6   Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
,
J. Dušková
7   Institute of Pathology, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
,
J. Kubinyi
8   Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
D. Michalský
9   1st Department of Surgery – Department of Abdominal, Thoracic Surgery and Traumatology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
K. Novák
10   Department of Urology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
,
J. Widimský Jr
1   Center for Hypertension, 3rd Medical Department – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
› Author Affiliations
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Publication History

Publication Date:
15 July 2015 (online)

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Biochemical Testing After Pheochromocytoma Removal: How Early?Horm Metab Res 2015; 47(09): e3-e3
DOI: 10.1055/s-0035-1559629

Abstract

Pheochromocytomas are catecholamine-producing tumors with typical clinical presentation. Tumor resection is considered as an appropriate treatment strategy. Due to its unpredictable clinical behavior, biochemical testing is mandatory to confirm the success of tumor removal after surgery. The aim of the study was to investigate the feasibility of a shorter interval of postoperative testing (earlier than the recommended 2–4 weeks according to recently published Guidelines). We investigated 81 patients with pheochromocytoma before and after surgery. Postoperative examination was performed of stable subjects after their transport from the surgical to the internal ward (7.1±2.2 days after surgery). Plasma metanephrines were used for the diagnosis of pheochromocytoma and confirmation of successful tumor removal. All subjects with pheochromocytoma had markedly elevated plasma metanephrines before surgery. No correlation between postoperative interval (the shortest being 3 days) and plasma metanephrine levels was found. Postoperative plasma metanephrine levels did not differ significantly from those taken at the one-year follow-up. In conclusion, we have shown that early postoperative diagnostic workup of subjects with pheochromocytoma is possible and may thus simplify early postoperative management of this clinical condition.

Key words

pheochromocytoma - paraganglioma - metanephrines - surgery
 

  • References

  • 1 Zelinka T, Eisenhofer G, Pacák K. Pheochromocytoma as a catecholamine producing tumor: implications for clinical practice. Stress 2007; 10: 195-203
    CrossrefPubMedSearch in Google Scholar
  • 2 Zelinka T, Petrák O, Turková H, Holaj R, Štrauch B, Kršek M, Brabcová-Vránková A, Musil Z, Dušková J, Kubinyi J, Michalský D, Novák K, Widimský Jr J. High incidence of cardiovascular complications in pheochromocytoma. Horm Metab Res 2012; 44: 379-384
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Prejbisz A, Lenders JW, Eisenhofer G, Januszewicz A. Mortality associated with phaeochromocytoma. Horm Metab Res 2013; 45: 154-158
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Pacak K. Preoperative management of the pheochromocytoma patient. J Clin Endocrinol Metab 2007; 92: 4069-4079
    CrossrefPubMedSearch in Google Scholar
  • 5 Mannelli M, Dralle H, Lenders JW. Perioperative management of pheochromocytoma/paraganglioma: is there a state of the art?. Horm Metab Res 2012; 44: 373-378
    Thieme ConnectPubMedSearch in Google Scholar
  • 6 Lenders JW, Duh QY, Eisenhofer G, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, Murad MH, Naruse M, Pacak K, Young Jr WF. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99: 1915-1942
    CrossrefPubMedSearch in Google Scholar
  • 7 Bravo EL, Tarazi RC, Gifford RW, Stewart BH. Circulating and urinary catecholamines in pheochromocytoma. Diagnostic and pathophysiologic implications. N Engl J Med 1979; 301: 682-686
    CrossrefPubMedSearch in Google Scholar
  • 8 Eisenhofer G, Peitzsch M. Laboratory Evaluation of Pheochromocytoma and Paraganglioma. Clin Chem 2014; 60: 1486-1499
    CrossrefPubMedSearch in Google Scholar
  • 9 Petrák O, Haluzíková D, Kaválková P, Štrauch B, Rosa J, Holaj R, Brabcová Vránková A, Michalský D, Haluzík M, Zelinka T, Widimský Jr J. Changes in Energy Metabolism in Pheochromocytoma. J Clin Endocrinol Metab 2013; 98: 1651-1658
    CrossrefPubMedSearch in Google Scholar
  • 10 Amar L, Fassnacht M, Gimenez-Roqueplo AP, Januszewicz A, Prejbisz A, Timmers H, Plouin PF. Long-term postoperative follow-up in patients with apparently benign pheochromocytoma and paraganglioma. Horm Metab Res 2012; 44: 385-389
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Lim V, Guo Q, Grant CS, Thompson B, Richards ML, Farley DR, Young Jr WF. Accuracy of adrenal imaging and adrenal venous sampling in predicting surgical cure of primary aldosteronism. J Clin Endocrinol Metab 2014; 99: 2712-2719
    Search in Google Scholar
  • 12 Amar L, Eisenhofer G. Clinical Question: Diagnosing phaeochromocytoma/paraganglioma in a patient presenting with critical illness: biochemistry versus imaging. Clin Endocrinol (Oxf) 2015; n/a-n/a
    PubMedSearch in Google Scholar
  • 13 Eisenhofer G, Kopin IJ, Goldstein DS. Catecholamine metabolism: a contemporary view with implications for physiology and medicine. Pharmacol Rev 2004; 56: 331-349
    CrossrefPubMedSearch in Google Scholar
  • 14 Tsirlin A, Oo Y, Sharma R, Kansara A, Gliwa A, Banerji MA. Pheochromocytoma: a review. Maturitas 2014; 77: 229-238
    CrossrefPubMedSearch in Google Scholar
  • 15 Galati SJ, Said M, Gospin R, Babic N, Brown K, Geer EB, Kostakoglu L, Krakoff LR, Leibowitz AB, Mehta L, Muller S, Owen RP, Pertsemlidis DS, Wilck E, Xiao GQ, Levine AC, Inabnet WB. The Mount Sinai Clinical Pathway for the Management of Pheochromocytoma. Endocr Pract 2015; 21: 368-382
    CrossrefPubMedSearch in Google Scholar
  • 16 Plouin P-F, Amar L, Lepoutre C. Phaeochromocytomas and functional paragangliomas: Clinical management. Best Pract Res Clin Endocrinol Metab 2010; 24: 933-941
    CrossrefPubMedSearch in Google Scholar
  • 17 Lee JA, Duh QY. Sporadic paraganglioma. World J Surg 2008; 32: 683-687
    CrossrefPubMedSearch in Google Scholar
  • 18 Darr R, Lenders JW, Hofbauer LC, Naumann B, Bornstein SR, Eisenhofer G. Pheochromocytoma – update on disease management. Ther Adv Endocrinol Metab 2012; 3: 11-26
    CrossrefPubMedSearch in Google Scholar
  • 19 Osinga TE, van den Eijnden MH, Kema IP, Kerstens MN, Dullaart RP, de Jong WH, Sluiter WJ, Links TP, van der Horst-Schrivers AN. Unilateral and Bilateral Adrenalectomy for Pheochromocytoma Requires Adjustment of Urinary and Plasma Metanephrine Reference Ranges. J Clin Endocrinol Metab 2013; 98: 1076-1083
    CrossrefPubMedSearch in Google Scholar