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Isolated Adrenal Mass in Patients with a History of Cancer: Remember Pheochromocytoma

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

In a patient with a history of cancer, an isolated adrenal mass is usually thought to be a metastasis. Although a biochemical work-up to rule out pheochromocytoma is recommended, some question its practicality. This study was undertaken to determine the incidence of functional adrenal lesions in patients with a history of cancer and examine predictive factors for the type of lesion.

Methods

At a single institution, 33 patients with an isolated adrenal mass and a history of cancer underwent surgical treatment. Patients’ records were retrospectively analyzed for type of adrenal lesion and other diagnostic parameters.

Results

There were 20 males and 13 females with a mean age of 58±2 years. Of these, 20 (61%) had adrenal metastases, 8 (24%) had pheochromocytomas, and 5 (15%) had adrenal adenomas. Usual diagnostic criteria, including presenting symptoms, primary tumor, and other demographic characteristics, did not consistently predict the pathology of the lesion.

Conclusions

Nearly 1 in 4 resected adrenal masses in patients with a history of cancer were pheochromocytomas. The high incidence of pheochromocytoma in this series supports a thorough work-up, irrespective of previous cancer. Therefore, remember one thing in patients with an isolated adrenal mass and a history of cancer: pheochromocytoma.

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Acknowledgments

The authors would like to thank David Greenblatt, MD, for his assistance in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Surgery, Section of Endocrine Surgery, H4/750 Clinical Science Center, 600 Highland Avenue, University of Wisconsin, Madison, WI, 53792, USA

    Joel T. Adler BA, Eberhard Mack MD, FACS & Herbert Chen MD, FACS

Authors
  1. Joel T. Adler BA
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  2. Eberhard Mack MD, FACS
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  3. Herbert Chen MD, FACS
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Corresponding author

Correspondence to Herbert Chen MD, FACS.

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Adler, J.T., Mack, E. & Chen, H. Isolated Adrenal Mass in Patients with a History of Cancer: Remember Pheochromocytoma. Ann Surg Oncol 14, 2358–2362 (2007). https://doi.org/10.1245/s10434-007-9426-4

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  • DOI: https://doi.org/10.1245/s10434-007-9426-4

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