Hager Casey, Grubb Stephen R
West Virginia Heart and Vascular Institute, South Charleston, USA.
W V Med J. 2011 Jul-Aug;107(4):24-6.
Pheochromocytoma is a well-recognized neuroendocrine tumor. Classical symptoms are well described, but recent studies have suggested that many patients are diagnosed incidentally. No studies have evaluated incidental pheochromocytoma with respect to year of diagnosis.
A retrospective study was performed from January 1992-November 2006 to evaluate the frequency of incidental pheochromocytoma. Patients were included if pathological specimens were available.
21 patients were included. 15/21 (71.4%) cases were incidentally discovered. 11/15 (73.3%) were diagnosed after 2000, while 4/15 (26.7%) were diagnosed before 2000. 15/21 (71.4%) patients had hypertension, and all 6 patients without hypertension had pheochromocytoma diagnosed incidentally. Only 3/21 (14.3%) patients were diagnosed by biochemical testing.
This observational study suggests an increasing number of incidental pheochromocytomas. Several possibilities for this observation include increased usage of imaging studies, decreased use of biochemical testing, and an increase in referring patients to surgeons for resection without an appropriate endocrine work-up. Referring physicians and surgeons alike should take note of this.
嗜铬细胞瘤是一种公认的神经内分泌肿瘤。经典症状已有详尽描述，但近期研究表明，许多患者是在偶然情况下被诊断出来的。尚无研究针对诊断年份对偶然发现的嗜铬细胞瘤进行评估。
进行了一项回顾性研究，时间跨度为1992年1月至2006年11月，以评估偶然发现的嗜铬细胞瘤的发生率。若有病理标本，则纳入患者。
共纳入21例患者。21例中有15例（71.4%）是偶然发现的。15例中有11例（73.3%）在2000年之后被诊断出来，而15例中有4例（26.7%）在2000年之前被诊断出来。21例患者中有15例（71.4%）患有高血压，6例无高血压的患者均为偶然诊断出嗜铬细胞瘤。21例患者中只有3例（14.3%）是通过生化检测诊断出来的。
这项观察性研究表明，偶然发现的嗜铬细胞瘤数量在增加。对此观察结果有几种可能的解释，包括影像学检查使用增加、生化检测使用减少，以及在未进行适当内分泌检查的情况下将患者转诊给外科医生进行切除手术的情况增加。转诊医生和外科医生都应注意这一点。
