Management of Exclusively Dopamine–Secreting Abdominal Pheochromocytomas
Centre des Maladies du Sein Deschênes-Fabia, Hôpital du Saint-Sacrement, Québec, Canada. Electronic address: .Journal of the American College of Surgeons (Impact Factor: 5.12). 11/2012; 216(2). DOI: 10.1016/j.jamcollsurg.2012.10.002
BACKGROUND: Dopaminomas are rare entities. Their management is different from classic pheochromocytomas. All abdominal dopaminomas reported previously are malignant tumors. Our objective was to assess the epidemiology of exclusively dopamine-secreting pheochromocytoma and their surgical and medical management. STUDY DESIGN: English and French literature indexed on PubMed from 1980 to 2011 was reviewed to provide a firm basis for the treatment of a patient. RESULTS: Only 9 cases of exclusively dopamine-secreting abdominal dopaminoma were retrieved from the literature between 1980 and 2011; all were malignant. Presentation, imagery, and biochemistry are variable and a dopaminoma is often found incidentally when investigating another lesion. Real incidence is unknown because of variable presentation. Meta-iodobenzylguanidine imagery might not be the best tool for exclusively dopamine-secreting dopaminomas. Dopamine secretion seems to be linked to malignancy. The use of α- and β-adrenergic blockers has been associated with life-threatening events in some patients. CONCLUSIONS: Excess unexplained urinary dopamine secretion should suggest the presence of a dopaminoma. Exclusively dopamine-secreting paragangliomas can be resected safely without the need for pre- or intraoperative α- or β-blockers.
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ABSTRACT: Extra-adrenal paraganglioma with isolated localization in the urinary bladder is a rare neuroendocrine tumor. Although the typical symptoms like headache, nausea, weight loss, flushing, heart palpitation or paroxysmal hypertension during micturition are well established, we present an unusual case of bladder paraganglioma, 'misdiagnosed' with basilar-type migraine due to headache for the past 8 years. As urologists linked the presence of a tumor (by CT) and symptoms connected with micturition, no cystoscopy and no transurethral resection of the bladder was performed prior to detailed diagnostic workup. After diagnosis of an extra-adrenal paraganglioma, the patient was scheduled for open partial cystectomy. In consideration of the fact that bladder paraganglioma is an infrequent genitourinary cancer, this case report clearly points out the importance of an exact anamnesis and clinical examination to minimize the probability of misdiagnosis with possible fatal consequences in any case with clinical suspicion of bladder paraganglioma.Urologia Internationalis 05/2013; 92(4). DOI:10.1159/000348829 · 1.43 Impact Factor
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ABSTRACT: For more than 20 years, measurement of catecholamines in plasma and urine in clinical chemistry laboratories has been the cornerstone of the diagnosis of neuroendocrine tumors deriving from the neural crest such as pheochromocytoma (PHEO) and neuroblastoma (NB), and is still used to assess sympathetic stress function in man and animals. Although assay of catecholamines in urine are still considered the biochemical standard for the diagnosis of NB, they have been progressively abandoned for excluding/confirming PHEOs to the advantage of metanephrines (MNs). Nevertheless, catecholamine determinations are still of interest to improve the biochemical diagnosis of PHEO in difficult cases that usually require a clonidine-suppression test, or to establish whether a patient with PHEO secretes high concentrations of catecholamines in addition to metanephrines. The aim of this chapter is to provide an update about the catecholamine assays in plasma and urine and to show the most common pre-analytical and analytical pitfalls associated with their determination.10/2013; 27(5):713-723. DOI:10.1016/j.beem.2013.06.004
- Current problems in cancer 03/2014; 38(1):7-41. DOI:10.1016/j.currproblcancer.2014.01.001 · 0.53 Impact Factor
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