This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Diagnosis

Authoring team

A diagnosis of phaeochromocytoma can be confirmed from:

  • biochemical confirmation
    • 24 hour urinary free catecholamines, VMA's
    • high performance liquid chromatography for catecholamines - in plasma/urine
    • radioimmunoassay (RIA) for urinary/plasma metanephrines


      • in adrenal incidentalomas
        • 24-hour urinary fractionated metanephrines and catecholamines (1,2)
        • fractionated catecholamines in the 24-hour urinary specimen linked to dopamine-secreting neoplasms
        • when normal diagnosis can be excluded
      • phaeochromocytoma
        • plasma normetanephrine
          • the best single parameter- highest sensitivity and specificity (1)
          • test of choice for the diagnosis or exclusion
        • serum VMA and serum creatinine levels elevated
        • serum CgA significantly higher
          • chromogranin- A (CgA) is secreted by chromaffin cells (3)

  • tumor localization
    • MRI
    • computerized tomography (CT) of the abdomen
      • detect lesions as small as 0.5 inches
      • imaging phenotype - shows characteristics of an adrenal mass on imaging (1)
        • increased attenuation on CT
        • prominent vascularity
        • delayed washout of contrast medium

  • confirmation
    • increased uptake of a radiolabelled catecholamine precursor in the site of the tumour
    • meta-iodobenzyl guanidine (MIBG, I-131 or 123) scintigraphy has been used to identify metastases, recurrent tumors and tumors in rare sites such as the pericardium and urinary bladder
    • MIBG is an adrenergic tissue localizing agent resembling norepinephrine

  • MRI and MIBG scintigraphy are more sensitive than CT

Older investigations/tests that may be used in the diagnostic workup:

  • clonidine suppression test
  • pentolinium suppression test
  • adrenal angiography

Reference:

  1. Unger N et al.Diagnostic value of various biochemical parameters for the diagnosis of pheochromocytoma in patients with adrenal mass. Eur J Endocrinol. 2006 Mar;154(3):409-17.
  2. Young MF. The Incidentally Discovered Adrenal Mass Young WF Jr N Engl J Med 2007; 356:601.
  3. Giovanella L et al. Diagnostic value of serum chromogranin-A combined with MIBG scintigraphy in patients with adrenal incidentalomas. Q J Nucl Med Mol Imaging. 2007 Jun 1.

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.