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Biochemical Diagnosis and Localization of Pheochromocytoma
Can We Reach a Consensus?
ASHLEY GROSSMANa,
KAREL PACAKb,
ANNA SAWKAc,
JACQUES W. M LENDERSd,
DEBRA HARLANDERe,
ROBERT T PEASTONf,
RODNEY REZNEKg,
JAMES SISSONh AND
GRAEME EISENHOFERi
a Department of Endocrinology, St. Bartholomew's Hospital, West Smithfield, London, UK b Reproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA c Department of Medicine, University of Toronto, Toronto, Ontario, Canada d Department of General Internal Medicine, St. Radboud University Hospital, Nijmegen, the Netherlands e Pheochromocytoma Support Group, Camden, New York 13316, USA f Department of Clinical Biochemistry, Freeman Hospital, Newcastle upon Tyne, UK g Division of Radiology, St. Bartholomew's Hospital, West Smithfield, London, UK h Department of Radiology, University of Michigan Hospitals, Ann Arbor, Michigan 48109, USA i Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892, USA
Key Words: pheochromocytoma • biochemical diagnosis • metanephrines • catecholamines • localization • computed tomography • magnetic resonance imaging • MIBG • positron emission tomography
Address for correspondence: Ashley Grossman, M.D., F.R.C.P., FMed. Sci., Department of Endocrinology, St. Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. Voice: 44 20 760 18343, fax: 44 20 760 18505. e-mail: a.b.grossman{at}qmul.ac.uk
Pheochromocytomas can have a highly variable presentation, making diagnosis challenging. To think of the tumor represents the crucial initial step, but establishing the diagnosis requires biochemical evidence of excessive catecholamine production and imaging studies to localize the source. Currently, however, there exist no generally agreed upon guidelines based on which tests and testing algorithms should be used to confirm and locate or exclude a suspected pheochromocytoma. Choice of biochemical tests and imaging studies instead usually depends on institutional experience. At the First International Symposium on Pheochromocytoma (ISP2005), held in Bethesda in October 2005, a panel of experts and patient representatives discussed current problems and available options for tumor diagnosis and localization and formulated recommendations, which were subsequently agreed upon by those in attendance at the meeting. This article summarizes the discussion and recommendations derived from that session.
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The Utility of Metaiodobenzylguanidine (MIBG) Scintigraphy in Patients with Pheochromocytoma
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R. T Peaston and S. Ball
Biochemical detection of phaeochromocytoma: why are we continuing to ignore the evidence?
Ann Clin Biochem,
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45(1):
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A. Chrisoulidou, G. Kaltsas, I. Ilias, and A. B Grossman
The diagnosis and management of malignant phaeochromocytoma and paraganglioma
Endocr. Relat. Cancer,
September 1, 2007;
14(3):
569 - 585.
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K. Pacak, G. Eisenhofer, A. Grossman, and I. Gavras
The Incidentally Discovered Adrenal Mass
N. Engl. J. Med.,
May 10, 2007;
356(19):
2005 - 2006.
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