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
Source: PubMed


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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