Clifton-Bligh Roderick
a University of Sydney, Sydney, NSW, Australia and Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
Expert Rev Endocrinol Metab. 2013 Jan;8(1):47-57. doi: 10.1586/eem.12.76.
Pheochromocytomas or functioning paragangliomas can present in a dramatic manner with headache, palpitations and sometimes shock, but many occur with few symptoms despite at times markedly elevated catecholamine levels. Hypertension is not invariable, and may be paroxysmal. Increased diligence in the diagnosis of presymptomatic pheochromocytoma/paraganglioma is warranted from autopsy studies, suggesting that many of these tumors may be fatal at first presentation. Fortunately, an increasing number of pheochromocytomas/paragangliomas are now diagnosed before the advent of symptoms, either as an incidental finding on abdominal imaging or by targeted surveillance in subjects with known genetic susceptibility. The challenges and pitfalls associated with diagnosis of these silent pheochromocytoma/paragangliomas are reviewed in this article.
嗜铬细胞瘤或功能性副神经节瘤可能以剧烈头痛、心悸甚至休克的形式出现，但许多病例尽管有时儿茶酚胺水平显著升高，症状却很少。高血压并非必然出现，且可能是阵发性的。尸检研究表明，有必要更加勤勉地诊断无症状性嗜铬细胞瘤/副神经节瘤，因为许多这类肿瘤在首次出现时可能是致命的。幸运的是，现在越来越多的嗜铬细胞瘤/副神经节瘤在出现症状之前就被诊断出来，要么是腹部影像学检查时偶然发现，要么是对已知有遗传易感性的受试者进行靶向监测时发现。本文将对这些无症状性嗜铬细胞瘤/副神经节瘤诊断中存在的挑战和陷阱进行综述。
