Disease Characteristics and management outcome of patients with Pheochromocytoma in TASH Follow-up clinics:A 10-year Retrospective Review
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Date
2020-12
Authors
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Addis Abeba University
Abstract
Background: Pheochromocytomas are catecholamine-secreting tumors, the majority of which
arise from the adrenal medulla. Untreated, they are potentially lethal; early diagnosis and treatment
offer a good chance of cure. It accounts for 0.2% of patients with Hypertension in western world.
Limited data exists regarding pheochromocytoma in developing world. Knowing disease
characteristics and presentation in this unstudied population helps to diagnose pheochromocytoma
early.
Objectives: The objective of this study was to review the disease characteristics and management
outcome of patients with pheochromocytoma among patients who were evaluated in Tikur
Anbessa Specialized hospital, Addis Ababa Ethiopia over a 10-year period.
Methodology: Institution based retrospective cross sectional study design was used and all
patients with pheochromocytoma evaluated from 2010 to 2020 medical records were reviewed,
pertinent data was collected and analyzed using SPSS 26. Frequency tabulation, Chi square test,
bivariate and multivariate logistic regression and Pearson correlation were used to study the
relationship among different variables.
Results: Twenty-eight patients were included in the study, of which 43% were male and 57%
female. The mean age was37 years (range 16–67). Incident of diagnosis was after the patients were
symptomatic in 75% of patients and after incidental discovery of adrenal mass in 25% of patients.
The median tumor size was 6 cm, and mean of 5.8±1.6cm, 30% were larger than 6 cm. 75% were
located in the adrenal gland (n=21, 71% unilateral, 3.6% bilateral), and 21.4%(n=6) were extraadrenal.
The
most
common
extra
adrenal
site
was
intra-abdominal paraganglioma (n=4, 14.3%).
There were 3 patients (10.7%) with malignant pheochromocytoma as suggested by imaging
features and recurrence. Clinical diagnosis of pheochromocytoma associated genetic syndrome
was made in 3(10.7%) patients, MEN 2a in two patients and vHL in one patient. Surgical cure rate
among symptomatic pheochromocytoma patients was 93.5% (n= 15). Although No significant
predictor of risk of malignancy or risk of recurrence was found in this study, the trend was towards
higher risk of recurrence for patients who are male and symptomatic at the time of diagnosis with
extra adrenal location of the tumor. On the other hand, being not operated was associated with increased risk having persistent symptoms (AOR: 58 P value: 0.006) and being older age at
diagnosis (AOR: 0.7 P value: 0.04) was associated with decreased risk.
Conclusion and recommendation: Majority of patients with pheochromocytoma are
symptomatic with classic symptoms, targeted screening with goal of early detection and surgical
management is recommended. Large scale study with prospective follow up is necessary to known
the burden of this rarely reported potentially malignant neoplasm.
Description
Keywords
Pheochromocytoma ,Patients