A patient with a large recurrent pheochromocytoma demonstrating the pitfalls of diagnosis

作者：Singer Joerg; Koch Christian A; Kassahun Woubet; Lamesch Peter; Eisenhofer Graeme; Kluge Regine; Lincke Thomas; Seiwerts Matthias; Borte Gudrun; Schierle Katrin; Paschke Ralf^*

来源：Nature Reviews Endocrinology, 2011, 7(12): 749-755.

DOI：10.1038/nrendo.2011.132

Background. A 59-year-old man presented for a follow-up, 6 years after surgery for a large pheochromocytoma. He had suffered from diabetes mellitus, hypertension and abdominal pain in the right flank region. Previous postoperative follow-up did not reveal tumor recurrence.
Investigation. Measurement of plasma free metanephrine and normetanephrine by high-performance liquid chromatography and radioimmunoassay; I-123-metaiodobenzylguanidine (MIBG) scintigraphy; hybrid I-123-MIBG single-photon emission CT (SPECT)-CT; MRI; testing for plasma norepinephrine and epinephrine; intraoperative ultrasonography; histological staining for chromogranin A and synaptophysin; and postoperative F-18-dihydroxyphenylalanine (DOPA) PET scan.
Diagnosis. Recurrent pheochromocytoma.
Management. Laparotomy with tumor resection. Reduction of antihypertensive medications. Further follow-up by MRI, hybrid I-123-MIBG SPECT-CT and testing for plasma catecholamines and free metanephrines.

• 出版日期2011-12