gms | German Medical Science

29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Hochdruckliga e. V. DHL ® - Deutsche Hypertonie Gesellschaft Deutsches Kompetenzzentrum Bluthochdruck

23. bis 25.11.2005, Berlin

Diagnostic problems with Pheochromocytoma

Meeting Abstract

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  • I. Balazovjeck - Comenius Unviersity Hospital, Bratislava
  • I. Makaiova - Comenius Unviersity Hospital, Bratislava
  • I. Vacula - Comenius Unviersity Hospital, Bratislava

Hypertonie 2005. 29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Berlin, 23.-25.11.2005. Düsseldorf, Köln: German Medical Science; 2006. Doc05hochP162

The electronic version of this article is the complete one and can be found online at:

Published: August 8, 2006

© 2006 Balazovjeck et al.
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From micronodular adenomatosis to giant adenomas /A/ can be a morphological substrate for Pheochromocytoma /Pheo/ On the basis of discrimination analysis of subjective symptoms and objective signs of the disease Pheo can be deistinguished from EH even without data on catecholamines/ CA/ values what can be used for preliminary screening of GP.Urinary CA in 98O patints /pat/with EH wit Pheo was found in 54 pat. DBH activity has no differentiating values in determining dg of Pheo.If the disease persist for a long period Catecholamine heart muscle disease develops and can be detected by ab abalysisi of the clinical picture,the electrocardiogram and schocardiograúhic examination. Adrenaline producing adenomas have more frequent arrhytmias without hypertension,for example in familiar Pheo MEN II detectable with Ret oncogen.

We have no exact anatomical, histological and histochemical criterion and no biochemical markers of malignancy in Pheo. Dopamine in urin and blood had no differentiating value to determine malignancy of Pheo. A sufficiently precise method for localisation of A is the computer tomography /CT/ Nuclear magnetic resonance has only small adventage against CT. Positron emission tomography/PET with l8FDGfluorodeoxyglucose/can confirm the viability of lesion, and suspect malignancy of tumor but the result is not specific. The future of this Dg method lies in the development of other positron radiopharmaceuticals. Angiography is too invasive for pat with Pheo but determination of CA in plasma from various level of vena cava and vena renalis can prove hormonal activity of adenomas. One of the most specific routine localisation method is wholebody scintigraphy and SPECT with 123-MIBG which help to localise adenomas and confirm its hormonal activity with high sensitivity and spesicificity also in axtraadrenal sites. In spite of many diagnostic problems detection of disease helps to cure one of the most serious forms of hypertension.