S K Zawadzka-Leska1, M Radziszewski1, K Malec1, A Stadnik2, U Ambroziak3. 1. Medical University of Warsaw, Student Scientific Group ENDOCRINUS, Warsaw, Poland. 2. Medical University of Warsaw, 2 Department of Clinical Radiology, Warsaw, Poland. 3. Medical University of Warsaw, Dept. of Internal Medicine and Endocrinology, Warsaw, Poland.
Abstract
CONTEXT: Some adrenal tumors, such as pheochromocytoma, can be life-threatening. Therefore it is crucial to distinguish them from other lesions, especially prior to surgery. Chromogranin A (CgA) seems to potentially be a good marker for tumors of chromaffin origin. OBJECTIVE: To assess the differentiating value of CgA in the diagnostic work-up of pheochromocytoma. DESIGN: Retrospective study of operated patients with adrenal incidentaloma with lesions > 10 Hounsfield's units (HU) on CT. SUBJECTS AND METHODS: Thirty patients (11 males, 19 females; aged 61.5±21 years) were enrolled in the study. Patients using medications interfering with the assessment of CgA and metanephrines were excluded. Two groups were formed: those with pheochromocytoma (Ph, n=16) and those with non-pheochromocytoma (N-Ph, n=14) lesions. Data included radiological features of masses, serum CgA and 24-hour urine metanephrines (24 - HUM) concentrations. RESULTS: No difference in 24-HUM level nor tumor size or density was found between groups Ph and N-Ph. Median serum CgA concentration was higher in Ph group compared to the N-Ph: 99.35 (68.12-172.73) vs. 52.92 (34.37-101.26) ng/mL, respectively (P=0.04). In Ph group, the size of the lesion correlated negatively with density (r= -0.53, P=0.042). No significant correlation in CgA, 24-HUM, density or size of the lesion was found. Performed curve receiver operating characteristic (ROC) showed AUC=0.7232 for CgA. Taking into account CgA serum value of ≤ 50 ng/mL (sensitivity: 93.75%, specificity: 50.00%, P=0.012), we proposed an algorithm for management of lesions > 10 HU on CT. CONCLUSION: CgA level ≤ 50 ng/mL might be useful in initial screening evidence for the exclusion of pheochromocytoma. It is crucial to eliminate factors interfering with the measurements.
CONTEXT: Some adrenal tumors, such as pheochromocytoma, can be life-threatening. Therefore it is crucial to distinguish them from other lesions, especially prior to surgery. Chromogranin A (CgA) seems to potentially be a good marker for tumors of chromaffin origin. OBJECTIVE: To assess the differentiating value of CgA in the diagnostic work-up of pheochromocytoma. DESIGN: Retrospective study of operated patients with adrenal incidentaloma with lesions > 10 Hounsfield's units (HU) on CT. SUBJECTS AND METHODS: Thirty patients (11 males, 19 females; aged 61.5±21 years) were enrolled in the study. Patients using medications interfering with the assessment of CgA and metanephrines were excluded. Two groups were formed: those with pheochromocytoma (Ph, n=16) and those with non-pheochromocytoma (N-Ph, n=14) lesions. Data included radiological features of masses, serum CgA and 24-hour urine metanephrines (24 - HUM) concentrations. RESULTS: No difference in 24-HUM level nor tumor size or density was found between groups Ph and N-Ph. Median serum CgA concentration was higher in Ph group compared to the N-Ph: 99.35 (68.12-172.73) vs. 52.92 (34.37-101.26) ng/mL, respectively (P=0.04). In Ph group, the size of the lesion correlated negatively with density (r= -0.53, P=0.042). No significant correlation in CgA, 24-HUM, density or size of the lesion was found. Performed curve receiver operating characteristic (ROC) showed AUC=0.7232 for CgA. Taking into account CgA serum value of ≤ 50 ng/mL (sensitivity: 93.75%, specificity: 50.00%, P=0.012), we proposed an algorithm for management of lesions > 10 HU on CT. CONCLUSION: CgA level ≤ 50 ng/mL might be useful in initial screening evidence for the exclusion of pheochromocytoma. It is crucial to eliminate factors interfering with the measurements.
Authors: José A Jiménez-Heffernan; Blanca Vicandi; Pilar López-Ferrer; Pilar González-Peramato; Ana Pérez-Campos; José M Viguer Journal: Acta Cytol Date: 2006 Jul-Aug Impact factor: 2.319
Authors: G P Bernini; A Moretti; M Borgioli; M Bardini; P Miccoli; P Berti; F Basolo; P Faviana; R Birindelli; A Salvetti Journal: J Endocrinol Invest Date: 2004-10 Impact factor: 4.256
Authors: Nicole Unger; Christian Pitt; Ingo Lopez Schmidt; Martin K Walz; Kurt W Schmid; Thomas Philipp; Klaus Mann; Stephan Petersenn Journal: Eur J Endocrinol Date: 2006-03 Impact factor: 6.664
Authors: Lucinda M Gruber; Veljko Strajina; Irina Bancos; M Hassan Murad; Benzon M Dy; William F Young; David R Farley; Melanie L Lyden; Geoffrey B Thompson; Travis J McKenzie Journal: Gland Surg Date: 2020-04
Authors: V Vukomanovic; M Matovic; A Djukic; V Ignjatovic; K Vuleta; S Djukic; I Simic Vukomanovic Journal: Acta Endocrinol (Buchar) Date: 2020 Jul-Sep Impact factor: 0.877