Biochemical Diagnosis and Localization of Pheochromocytoma

Can We Reach a Consensus?

GROSSMAN, ASHLEY
PACAK, KAREL
SAWKA, ANNA
LENDERS, JACQUES W. M
HARLANDER, DEBRA
PEASTON, ROBERT T
REZNEK, RODNEY
SISSON, JAMES
EISENHOFER, GRAEME

^aDepartment of Endocrinology, St. Bartholomew's Hospital, West Smithfield, London, UK
^bReproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA
^cDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
^dDepartment of General Internal Medicine, St. Radboud University Hospital, Nijmegen, the Netherlands
^ePheochromocytoma Support Group, Camden, New York 13316, USA
^fDepartment of Clinical Biochemistry, Freeman Hospital, Newcastle upon Tyne, UK
^gDivision of Radiology, St. Bartholomew's Hospital, West Smithfield, London, UK
^hDepartment of Radiology, University of Michigan Hospitals, Ann Arbor, Michigan 48109, USA
ⁱClinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892, USA

Address for correspondence: Ashley Grossman, M.D., F.R.C.P., FMed. Sci., Department of Endocrinology, St. Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. Voice: 44 20 760 18343, fax: 44 20 760 18505. e-mail: [email protected]

Annals of the New York Academy of Sciences 1073(1):p 332-347, August 2006.

Pheochromocytomas can have a highly variable presentation, making diagnosis challenging. To think of the tumor represents the crucial initial step, but establishing the diagnosis requires biochemical evidence of excessive catecholamine production and imaging studies to localize the source. Currently, however, there exist no generally agreed upon guidelines based on which tests and testing algorithms should be used to confirm and locate or exclude a suspected pheochromocytoma. Choice of biochemical tests and imaging studies instead usually depends on institutional experience. At the First International Symposium on Pheochromocytoma (ISP2005), held in Bethesda in October 2005, a panel of experts and patient representatives discussed current problems and available options for tumor diagnosis and localization and formulated recommendations, which were subsequently agreed upon by those in attendance at the meeting. This article summarizes the discussion and recommendations derived from that session