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Chirurg 2019 Feb 13. Epub 2019 Feb 13.

Sektion Endokrine Chirurgie, Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.

Expert Rev Endocrinol Metab 2014 Mar 16;9(2):123-135. Epub 2014 Feb 16.

a Department of Endocrinology and Metabolism, Cleveland Clinic Foundation, Cleveland, OH, USA.

The current work-up of a patient suspected to have a pheochromocytoma starts with the measurement of plasma or urine metanephrines. Notably, up to a quarter of these patients will have a false positive result. When the plasma or urine metanephrines are less than the 4-fold upper limit of normal, clinicians struggle between the fear of missing a potentially fatal condition and ordering costly follow up tests. Read More

J Postgrad Med 2019 Jan-Mar;65(1):44-46

Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

We report a 49-year-old woman who presented with a hypertensive crisis and acute heart failure and reduced left ventricular systolic function. An abdominal ultrasonography revealed a huge lobulated heterogeneous mass at the lower pole of the right kidney and a mass over the left suprarenal area, which were further delineated by magnetic resonance imaging. The patient underwent laparoscopic right radical nephrectomy and left adrenalectomy. Read More

Int J Surg Case Rep 2019 Jan 9;55:7-10. Epub 2019 Jan 9.

Department of Surgery, Kendall Regional Medical Center, Miami, FL, United States.

Introduction: Pheochromocytoma are neuroendocrine tumors that arise from sympathetic chromaffin cells within the adrenal medulla. They principally secrete catecholamines, potentially causing life-threatening cardiovascular complications. A myriad of symptomatology and clinical findings are associated with pheochromocytoma, including a catecholamine-induced dilated cardiomyopathy. Read More

Rev Esp Med Nucl Imagen Mol 2019 Jan 7. Epub 2019 Jan 7.

Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria.

Objective: F-Fluoro-L-dihydroxyphenylalanine (F-DOPA) PET offers high sensitivity and specificity in the imaging of non-malignant extra-adrenal paraganglioma (PGL) and pheochromocytoma (PHEO) but lower sensitivity in metastatic disease. These tumours are of neuroendocrine origin and can be detected by Ga-DOTA-Tyr3-octreotide (Ga-DOTA-TOC) PET. Therefore, we compared Ga-DOTA-TOC and F-DOPA as radiolabels for PET/CT imaging for the diagnosis of metastatic extra-adrenal PGL and PHEO. Read More

Health Sci Rep 2018 Mar 20;1(3):e22. Epub 2017 Dec 20.

Internal Medicine and Endocrinology, Department of Internal Medicine, Division of Endocrinology Cukurova University Medical Faculty Adana Turkey.

Background: Adrenal incidentalomas are adrenal masses that are discovered by imaging tests performed for other reasons.

Aims: In this retrospective study, we analysed 229 Turkish patients with adrenal masses and who presented with or without complaints.

Study Design: Descriptive retrospective study and review of the literature. Read More

J Med Case Rep 2019 Jan 5;13(1). Epub 2019 Jan 5.

Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8555, Japan.

Background: There are several reports of pheochromocytoma crisis triggered by systemic glucocorticoid administration. However, pheochromocytoma crisis after intra-articular glucocorticoid administration has been rarely reported.

Case Presentation: A 45-year-old Japanese man presented to our hospital with a sudden, severe headache. Read More

Pediatr Nephrol 2019 Jan 2. Epub 2019 Jan 2.

Division of Pediatric Nephrology and Hypertension, Children's Hospital of Michigan, Wayne State University School of Medicine, 5th Floor, Carl's Building, 3901 Beaubien Blvd, Detroit, MI, 48201, USA.

Pheochromocytomas and paragangliomas (PPGLs) generally grouped together are rare catecholamine-secreting endocrine tumors. Symptoms of catecholamine excess are non-specific and therefore a high index of suspicion in children with sustained hypertension, family history of endocrine tumors, or features of syndromes associated with PPGLs leads to a timely diagnosis and treatment. Free metanephrines in the plasma or 24-h urine are the preferred tests to establish catecholamine excess. Read More

J Biophotonics 2018 Dec 30:e201800289. Epub 2018 Dec 30.

Department of Physics, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.

Temporally low-coherent optical diffraction tomography (ODT) is proposed and demonstrated based on angle-scanning Mach-Zehnder interferometry. Using a digital micromirror device based on diffractive tilting, the full-field interference of incoherent light is successfully maintained during every angle-scanning sequences. Further, current ODT reconstruction principles for temporally incoherent illuminations are thoroughly reviewed and developed. Read More

Clin Endocrinol (Oxf) 2018 Dec 27. Epub 2018 Dec 27.

Department of Diabetes and Endocrinology, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.

The succinate dehydrogenase (SDH) enzyme complex functions as a key enzyme coupling the oxidation of succinate to fumarate in the citric acid cycle. Inactivation of this enzyme complex results in the cellular accumulation of the oncometabolite succinate, which is postulated to be a key driver in tumorigenesis. Succinate accumulation inhibits 2-oxoglutarate-dependent dioxygenases, including DNA and histone demethylase enzymes and hypoxic gene response regulators. Read More

Cancers (Basel) 2018 Dec 15;10(12). Epub 2018 Dec 15.

Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Building 10, Room 1E-3140, Bethesda, MD 20892, USA.

Adrenocortical carcinoma (ACC) and pheochromocytoma and paraganglioma (PPGL) are defined by clinicopathological criteria and can be further sub-divided based on different molecular features. Whether differences between these molecular subgroups are significant enough to re-challenge their current clinicopathological classification is currently unknown. It is also not fully understood to which other cancers ACC and PPGL show similarity to. Read More

Hinyokika Kiyo 2018 Nov;64(11):435-438

The Department of Urology, Osaka National Hospital.

A 69-year-old woman was admitted to the previous hospital because of a right adrenal tumor detected by a medical checkup. Although the tumor was diagnosed as non-functional adrenal adenoma, abdominal computed tomography (CT) revealed a left renal mass which was suspected to be renal cell carcinoma. Chest CT seeking for metastatic lesions revealed lung cancer of the left lung. Read More

Clinics (Sao Paulo) 2018 Dec 10;73(suppl 1):e756s. Epub 2018 Dec 10.

Unidade de Suprarrenal, Laboratorio de Hormonios e Genetica Molecular LIM/42, Servico de Endocrinologia e Metabologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Malignancy must be considered in the management of adrenal lesions, including those incidentally identified on imaging studies. Adrenocortical carcinomas (ACCs) are rare tumors with an estimated annual incidence of 0.7-2 cases per year and a worldwide prevalence of 4-12 cases per million/year. Read More

EPMA J 2018 Dec 21;9(4):421-429. Epub 2018 Sep 21.

7Department of Radiology, Keck Medical Center of USC, Los Angeles, CA USA.

Objectives: This study aims to define a radiomic signature for pre-operative differentiation between subclinical pheochromocytoma (sPHEO) and lipid-poor adrenal adenoma (LPA) in adrenal incidentaloma. The goal was to apply a predictive, preventive, and personalized medical approach to the management of adrenal tumors.

Patients And Methods: This retrospective study consisted of 265 consecutive patients (training cohort, 212 (LPA, 145; sPHEO, 67); validation cohort, 53 (LPA, 36; sPHEO, 17)). Read More

Front Endocrinol (Lausanne) 2018 27;9:515. Epub 2018 Nov 27.

Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States.

Pheochromocytomas and paragangliomas (PCCs/PGLs) are rare commonly benign neuroendocrine tumors that share pathology features and clinical behavior in many cases. While PCCs are chromaffin-derived tumors that arise within the adrenal medulla, PGLs are neural-crest-derived tumors that originate at the extraadrenal paraganglia. Pheochromocytoma-paraganglioma (PPGL) syndromes are rapidly evolving entities in endocrinology and oncology. Read More

J Intern Med 2019 Feb 15;285(2):187-204. Epub 2019 Jan 15.

Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden.

Pheochromocytoma and paraganglioma (PPGL) are rare tumours and at least 30% are part of hereditary syndromes. Approximately 20% of hereditary PPGL are caused by pathogenic germ line variants in genes of the succinate dehydrogenase complex (SDHx), TMEM127 or MAX. Herein we present guidelines regarding genetic testing of family members and their surveillance based on a thorough literature review. Read More

Hum Pathol 2018 Dec 7. Epub 2018 Dec 7.

Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Haartmaninkatu 3, (P.O. Box 21, ), FIN-00014 University of Helsinki, Helsinki, Finland.

Pheochromocytomas (PHEOs) and paragangliomas (PGLs) are neuroendocrine tumors (NETs) that express somatostatin receptors (SSTRs), a phenomenon that constitutes a basis for tumor imaging and treatment with somatostatin analogues and Peptide Receptor Radionuclide Therapy (PRRT). We studied the immunohistochemical expression of SSTR1-5 in 151 primary tumors, including 14 metastasized and 16 SDHB-deficient tumors. SSTR2 and SSTR3 were most abundantly present in these tumors, whereas the tumors were mostly negative for SSTR1, SSTR4 and SSTR5. Read More

Prog Urol 2018 Nov 27;28(12S):S175-S193. Epub 2018 Oct 27.

Service d'urologie, hôpital d'instruction des armées Sainte-Anne, BP 600, 83800 Toulon cedex 09, France; Service d'urologie, hôpital européen Georges-Pompidou, université Paris Descartes, AP-HP, 75015 Paris, France. Electronic address:

Objective: To update French oncology guidelines concerning adrenal cancer.

Methods: Comprehensive Medline search between 2016 and 2018 upon diagnosis, treatment and follow-up of adrenal cancer to update 2013 guidelines. Level of evidence was evaluated according to AGREE-II. Read More

J Clin Endocrinol Metab 2018 Nov 19. Epub 2018 Nov 19.

Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, MN, USA.

Context: Modern pheochromocytomas (PHEO) are often discovered by incidental finding on cross-sectional imaging or mutation-based genetic case detection testing. Little information is known about how these PHEO behave.

Objective: To describe the characteristics and behavior of PHEO discovered incidentally on imaging or through mutation-based genetic case detection testing. Read More

Radiol Med 2018 Nov 14. Epub 2018 Nov 14.

Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.

The past decade has witnessed a growing role and increasing use of whole-body magnetic resonance imaging (WB-MRI). Driving these successes are developments in both hardware and software that have reduced overall examination times and significantly improved MR imaging quality. In addition, radiologists and clinicians have continued to find promising new applications of this innovative imaging technique that brings together morphologic and functional characterization of tissues. Read More

Case Rep Gastrointest Med 2018 3;2018:8196051. Epub 2018 Oct 3.

Division of Gastroenterology and Hepatology, University of Florida and Malcom Randall VA Medical Center, Gainesville, FL, USA.

Primary adrenal leiomyosarcoma (PAL) is an extremely rare mesenchymal tumor with only a few isolated case reports in the medical literature. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or endoscopic ultrasound-guided core biopsy (EUS-CB) is a safe, effective modality for sampling lesions in the gastrointestinal tract and adjacent organs, including the adrenal glands. We describe the case of a 50-year-old male presenting with abdominal pain and unintentional weight loss over the course of one year. Read More

Chirurg 2019 Jan;90(1):3-8

Klinik für Endokrinologie, Diabetologie und Stoffwechsel, Universitätsklinikum Essen, Hufelandstr. 55, 45127, Essen, Deutschland.

An adrenal incidentaloma is an adrenal mass detected on imaging that was not performed for suspected adrenal disease. The prevalence is approximately 3% and increases up to 10% in older people. The risk of malignancy and a hormone excess have to be evaluated. Read More

Endocr Connect 2018 Sep 1. Epub 2018 Sep 1.

F Beuschlein, LMU München, Medizinische Klinik IV, Munich, Germany.

Context: 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). Read More

Surgery 2019 Jan 16;165(1):228-231. Epub 2018 Oct 16.

University of Tennessee Health Science Center, Department of Surgery, Division of Surgical Oncology, Memphis TN. Electronic address:

Background: Multifocal pheochromocytoma/paraganglioma presenting at an early age is commonly associated with a hereditary syndrome.

Case Report: A 29-year-old woman was referred for evaluation of multifocal pheochromocytoma/paraganglioma. Interestingly, her family history did not include pheochromocytoma/paraganglioma, and comprehensive genetic testing for the well-documented pheochromocytoma/paraganglioma susceptibility genes was negative. Read More

J Cancer 2018 8;9(19):3577-3582. Epub 2018 Sep 8.

Department of Radiology, Keck Medical Center of USC, Los Angeles, CA.

To evaluate the feasibility and accuracy of machine learning based texture analysis of unenhanced CT images in differentiating subclinical pheochromocytoma (sPHEO) from lipid-poor adenoma (LPA) in adrenal incidentaloma (AI). Seventy-nine patients with 80 LPA and 29 patients with 30 sPHEO were included in the study. Texture parameters were derived using imaging software (MaZda). Read More

Quant Imaging Med Surg 2018 Sep;8(8):853-875

Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China.

Besides ultrasound and nuclear medicine techniques, computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used to examine adrenal lesions in both symptomatic and asymptomatic patients. Some adrenal lesions have characteristic radiological features. If an adrenal nodule is discovered incidentally, determining whether the lesion is benign or malignant is of great importance. Read More

Clin Endocrinol (Oxf) 2019 Jan 28;90(1):31-46. Epub 2018 Nov 28.

Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.

Objective: With the discovery that familial phaeochromocytoma and paraganglioma syndrome can be caused by mutations in each subunit of the succinate dehydrogenase enzyme (SDH), has come the recognition that mutations in the individual subunits have their own distinct natural histories. Increased genetic screening is leading to the identification of increasing numbers of, mostly asymptomatic, gene mutation carriers and the implementation of screening strategies for these individuals. Yet there is, to date, no international consensus regarding screening strategies for asymptomatic carriers. Read More

Indian J Pathol Microbiol 2018 Oct-Dec;61(4):587-589

Department of Surgery, Maulana Azad Medical College, New Delhi, India.

Sporadic adrenal medullary hyperplasia (AMH) is a rare entity and mimics pheochromocytoma clinically as well as pharmacologically. It is characterized by increase in adrenal medullary cells with the expansion of cells into areas normally not seen. A 59-year-old male presented with chronic hypertension and raised 24-h urinary normetanephrine levels. Read More

J Nucl Med 2018 Oct 5. Epub 2018 Oct 5.

Department of Endocrine Neoplasia and Hormonal Disorders, U. of Texas M.D. Anderson Cancer Center, United States.

Patients with metastatic or unresectable (advanced) pheochromocytoma or paraganglioma (PPGL) have poor prognoses and few treatment options. This multicenter, phase 2 trial evaluated the efficacy and safety of high-specific-activity I-131 meta-iodobenzylguanidine (HSA I-131 MIBG) in patients with advanced PPGL. In this open-label, single-arm study, 81 PPGL patients were screened for enrollment, and 74 received a treatment-planning dose of HSA I-131 MIBG. Read More

Endocr Relat Cancer 2018 10 5;25(12):993-1004. Epub 2018 Oct 5.

Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.

Somatostatin receptor-targeting endoradiotherapy offers potential for treating metastatic pheochromocytomas and paragangliomas, an approach likely to benefit from combination radiosensitization therapy. To provide reliable preclinical in vivo models of metastatic disease, this study characterized the metastatic spread of luciferase-expressing mouse pheochromocytoma (MPC) cells in mouse strains with different immunologic conditions. Bioluminescence imaging showed that, in contrast to subcutaneous non-metastatic engraftment of luciferase-expressing MPC cells in NMRI-nude mice, intravenous cell injection provided only suboptimal metastatic spread in both NMRI-nude mice and hairless SCID (SHO) mice. Read More

Internist (Berl) 2018 Nov;59(11):1163-1179

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Campus Innenstadt, Ziemssenstr. 1, 80336, München, Deutschland.

Endocrine disorders are the most common causes of secondary hypertension. Early diagnosis and specific treatment are crucial for improvement of the prognosis. This article provides an overview on which clinical constellations point to an increased risk of secondary causes of hypertension. Read More

JAMA Surg 2018 Sep 26. Epub 2018 Sep 26.

Department of Surgery, Stanford University, Stanford, California.

Importance: Neuroendocrine tumors (NETs) express somatostatin receptors, which can be targeted with radiolabeled peptides. In a variety of solid tumors, radioguided surgery (RGS) has been used to guide surgical resection. Gallium 68 (68Ga) dota peptides have been shown to be more accurate than other radioisotopes for detecting NETs. Read More

Mayo Clin Proc Innov Qual Outcomes 2018 Mar 21;2(1):30-39. Epub 2017 Dec 21.

Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN.

Objective: To characterize large adrenal tumors (≥4 cm in diameter) and to identify features associated with malignancy.

Patients And Methods: We investigated the clinical, biochemical, and imaging characteristics in a large retrospective single-center cohort of patients with adrenal tumors of 4 cm or more in diameter during the period of January 1, 2000, through December 31, 2014.

Results: Of 4085 patients with adrenal tumors, 705 (17%) had adrenal masses measuring 4 cm or more in diameter; of these, 373 (53%) were women, with a median age of 59 years (range, 18-91 years) and median tumor size of 5. Read More

Zhonghua Yi Xue Za Zhi 2018 Sep;98(34):2727-2731

Department of Endocrinology, Peking University First Hospital, Beijing 100034, China.

To summarize the clinical characteristics of silent paraganglioma. A total of 247 pheochromocytoma cases in Peking University First Hospital between January 1993 and December 2015 were analyzed retrospectively.The cases were divided into two groups according to whether they had hypertension: non-silent group (193 cases) and silent group (53 cases), then the clinical characteristics between the groups were compared, and the clinical features of silent pheochromocytoma were reviewed. Read More

Ther Clin Risk Manag 2018 31;14:1547-1552. Epub 2018 Aug 31.

Department of Pediatrics I, Emergency Clinic Hospital for Children, "Iuliu Hatieganu" University of Medicine and Pharmacy,

Neurofibromatosis 1 (NF1) is an autosomal-dominant disorder with various clinical expressivity and complications. Arterial hypertension may be present in patients with NF1 and is secondary to vasculopathy or pheochromocytoma. We herein describe two children (17 and 4 years old) diagnosed late with NF1 after severe arterial hypertension had been discovered due to pheochromocytoma and middle aortic syndrome. Read More

Ann Transl Med 2018 Aug;6(15):293

Tulane University School of Medicine, Tulane Heart and Vascular Institute, New Orleans, Louisiana, USA.

Background: The accurate identification and diagnosis of secondary hypertension is critical, especially while atherosclerotic cardiovascular heart disease continues to be the leading cause of death in the industrialized world. Nevertheless, despite the existence of diagnostic tools, there are significant variations of the estimated prevalence of secondary hypertension, due to multiple etiologies and suboptimal recognition. This study demonstrates the results of using a systematic and protocolled approach to improve recognition of the presence of secondary hypertension. Read More

Wien Med Wochenschr 2019 Feb 4;169(1-2):25-32. Epub 2018 Sep 4.

Department of Nuclear Medicine, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.

Diagnostic imaging plays an important role in the detection of paraganglioma (PGL), pheochromocytoma (PCC), and neuroblastoma (NB). Anatomic imaging, for example CT or MRI, offers high sensitivity in these neuroendocrine tumors (NET) but only moderate specificity, often associated with difficulties in clearly distinguishing between NET and non-NET. Functional imaging, as in the use of different radioisotopes, is indispensable in oncological imaging. Read More

BMJ Case Rep 2018 Sep 4;2018. Epub 2018 Sep 4.

Internal Medicine, Providence Health System, Washington, District of Colombia, USA.

A 77-year-old woman was diagnosed with pheochromocytoma followed by adrenalectomy at age 57. Hyperparathyroidism without osteoprosis was diagnosed at age 58. At age 75, Dual Energy X-ray Absoptiometry (DEXA) revealed osteoporosis and sestamibi scan showed a left parathyroid adenoma. Read More

Medicine (Baltimore) 2018 Aug;97(35):e12184

Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences.

Rationale: Malignant pheochromocytoma in the spine is a rare disease without standard curative managements so far. The objective of this article is to report a very rare case of malignant pheochromocytoma with sacrum metastases causing severe lumbosacral pain, which was presented with acute radiculopathy and treated with three operations combined with cement augmentation and stabilization. The management of these unique cases has yet to be well-documented. Read More

Praxis (Bern 1994) 2018 Aug;107(17-18):977-984

1 Abteilung für Endokrinologie/Diabetologie, Luzerner Kantonsspital.

CME: Pheochromocytoma in the General Practice Abstract. Pheochromocytoma are rare tumors, usually symptomatic due to their hormonal activity with excessive catecholamine secretion. Because of their bright spectrum of clinical presentation, they are often undiagnosed. Read More

J Clin Endocrinol Metab 2019 Jan;104(1):7-12

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland.

Context: Multiple endocrine neoplasia type 2B (MEN2B) is characterized by early-onset medullary thyroid cancer in virtually all cases and a 50% lifetime risk of pheochromocytoma (PHEO) development. The literature on PHEO in patients with MEN2B is limited with most data being reported from adult studies that primarily address MEN2A.

Objective: The aim of the current study is to describe PHEO development in a cohort of pediatric patients with MEN2B. Read More

PLoS One 2018 14;13(8):e0201303. Epub 2018 Aug 14.

INSERM UMR U1068, CNRS UMR 7258, Aix-Marseille University, Cancer Research Center of Marseille, Marseille, France.

Succinate dehydrogenase subunit B and D (SDHB and SDHD) mutations represent the most frequent cause of hereditary pheochromocytoma and paraganglioma (PPGL). Although truncation of the succinate dehydrogenase complex is thought to be the disease causing mechanism in both disorders, SDHB and SDHD patients exihibit different phenotypes. These phenotypic differences are currently unexplained by molecular genetics. Read More

Nucl Med Mol Imaging 2018 Aug 3;52(4):254-265. Epub 2018 May 3.

1Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641 Japan.

Metaiodobenzylguanidine (MIBG) is structurally similar to the neurotransmitter norepinephrine and specifically targets neuroendocrine cells including some neuroendocrine tumors. Iodine-131 (I-131)-labeled MIBG (I-131 MIBG) therapy for neuroendocrine tumors has been performed for more than a quarter-century. The indications of I-131 MIBG therapy include treatment-resistant neuroblastoma (NB), unresectable or metastatic pheochromocytoma (PC) and paraganglioma (PG), unresectable or metastatic carcinoid tumors, and unresectable or metastatic medullary thyroid cancer (MTC). Read More

Surgery 2018 Nov 4;164(5):972-977. Epub 2018 Aug 4.

Department of Endocrine Surgery, Cleveland Clinic, OH. Electronic address:

Background: A number of small studies have reported the use of indocyanine green imaging during adrenalectomy. Nevertheless, imaging properties of different tumors and the indications for indocyanine green imaging use in adrenalectomy have not been defined.

Methods: This is an Institutional Review Board-approved retrospective review of a prospectively maintained database. Read More

Endocr J 2018 Nov 4;65(11):1093-1099. Epub 2018 Aug 4.

Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa 227-8501, Japan.

Changes in imaging findings and hormone levels before and after pheochromocytoma rupture, as well as detailed histopathology of resected tumors, have rarely been reported. A 52-year-old woman developed hypertension and diabetes mellitus in 2014, but despite treatment with antihypertensive and hypoglycemic drugs, good control was not achieved. On April 2, 2016, the patient started to have headaches and palpitations, and on April 6, she visited our hospital. Read More

Clin Med (Lond) 2018 Aug;18(4):345-347

Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

A 26-year-old man presented following blunt abdominal trauma to a regional major trauma centre for emergency embolisation of a retroperitoneal bleed from a presumed renal laceration. Imaging had also revealed a large right suprarenal mass. Embolisation resulted in a hypertensive crisis raising the suspicion of a metabolically active adrenal tumour. Read More

Clin Auton Res 2018 Aug 30;28(4):397-410. Epub 2018 Jul 30.

Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA.

Sympathetic neuroimaging is based on the injection of compounds that either radiolabel sites of the cell membrane norepinephrine transporter (NET) or that are taken up into sympathetic nerves via the NET and radiolabel intra-neuronal catecholamine storage sites. Detection of the radioactivity is by planar or tomographic radionuclide imaging. The heart stands out among body organs in terms of the intensity of radiolabeling of sympathetic nerves, and virtually all of sympathetic neuroimaging focuses on the left ventricular myocardium. Read More

Anticancer Res 2018 Aug;38(8):4767-4773

Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Aim: To elucidate the relationship among tumor attenuation of pre-contrast-enhanced (TApre) computed tomography (CT), washout rate and clear cell ratio (CCR) in adrenal adenoma (AA) and propose a new approach for diagnosing AA on dynamic CT.

Materials And Methods: The training set consisted of 43 AAs and 15 non-AAs, while the validation set comprised 44 AAs and 11 non-AAs. Using the training set, the pairwise correlation between CCR, TApre and washout rate in AA was evaluated by linear regression analysis. Read More

Pan Afr Med J 2018 23;29:168. Epub 2018 Mar 23.

Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital Arrazi, CHU Mohammed VI, Laboratoire de Recherche de Pneumo-Cardio-Immunopathologie et Métabolisme (PCIM), Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayad, Marrakech, Maroc.

The pheochromocytoma is a rare, but potentially serious, which can be revealed by pregnancy. Less than 250 cases described in the literature .The rarity of this association and similarity with pregnancy-induced hypertension explains the frequency of unknown diagnoses during pregnancy. Read More

BMJ Case Rep 2018 Jul 24;2018. Epub 2018 Jul 24.

Department of Medicine, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada.

The discovery of adrenal lesions during routine testing for hypertension requires focused consideration for adrenal overproduction of cortisol, aldosterone or metanephrines. An otherwise healthy 25-year-old woman presented with headaches, diaphoresis and hot flushes with grossly elevated urine catecholamines, normetanephrines and norepinephrine levels, yet normal metanephrines, epinephrine/epinephrine, cortisol and aldosterone levels. Subsequent functional uptake studies and scans identified bilateral adrenal adenomas consistent with phaeochromocytomas. Read More