Biopsy of pheochromocytomas and paragangliomas: Potential for disaster

Kimberly A. Vanderveen, Scott M. Thompson, Matthew R. Callstrom, William F. Young, Clive S. Grant, David R. Farley, Melanie L. Richards, Geoffrey B. Thompson

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Background: Pheochromocytomas and paragangliomas are highly vascular neuroendocrine neoplasms that often secrete catecholamines. Percutaneous biopsy has been associated with life-threatening hemorrhage, hypertensive crisis, capsular disruption with tumor implantation, and death. We sought to determine the outcomes of biopsy in 20 consecutive patients. Methods: We reviewed retrospectively the medical records of patients with biopsied pheochromocytomas and paragangliomas referred to our Endocrine Division for subsequent management between 1995 and 2005. Biopsy complications, operative findings, and outcomes were reviewed. Results: Twenty patients (14 pheochromocytomas and 6 paragangliomas) were biopsied percutaneously prior to referral. Mean tumor diameter was 6.4 cm (range, 1-15). Pre-biopsy biochemical testing was not performed in 90% of patients, and was negative in the remainder. Fourteen patients (70%) developed a biopsy-related complication, including: increased difficulty of the definitive operation in 7 of 17 (41%) operative cases with 1 patient requiring conversion to an open procedure; severe hypertension (15%); hematoma (30%); incorrect or inadequate biopsy (25%); severe pain (25%); and delay in surgical treatment (15%). Mean follow-up was 58 months, with 4 tumor-related deaths and 2 recurrences. Conclusion: Biochemical testing prior to biopsy of adrenal or suspicious retroperitoneal masses is critical to exclude a catecholamine-secreting neoplasm because serious complications and increased operative difficulty can result.

Original languageEnglish (US)
Pages (from-to)1158-1166
Number of pages9
JournalSurgery
Volume146
Issue number6
DOIs
StatePublished - Dec 2009
Externally publishedYes

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Paraganglioma
Pheochromocytoma
Disasters
Biopsy
Catecholamines
Neoplasms
Vascular Neoplasms
Conversion to Open Surgery
Hematoma
Medical Records
Referral and Consultation
Hemorrhage
Hypertension
Recurrence
Pain

ASJC Scopus subject areas

  • Surgery

Cite this

Vanderveen, K. A., Thompson, S. M., Callstrom, M. R., Young, W. F., Grant, C. S., Farley, D. R., ... Thompson, G. B. (2009). Biopsy of pheochromocytomas and paragangliomas: Potential for disaster. Surgery, 146(6), 1158-1166. https://doi.org/10.1016/j.surg.2009.09.013

Biopsy of pheochromocytomas and paragangliomas : Potential for disaster. / Vanderveen, Kimberly A.; Thompson, Scott M.; Callstrom, Matthew R.; Young, William F.; Grant, Clive S.; Farley, David R.; Richards, Melanie L.; Thompson, Geoffrey B.

In: Surgery, Vol. 146, No. 6, 12.2009, p. 1158-1166.

Research output: Contribution to journalArticle

Vanderveen, KA, Thompson, SM, Callstrom, MR, Young, WF, Grant, CS, Farley, DR, Richards, ML & Thompson, GB 2009, 'Biopsy of pheochromocytomas and paragangliomas: Potential for disaster', Surgery, vol. 146, no. 6, pp. 1158-1166. https://doi.org/10.1016/j.surg.2009.09.013
Vanderveen KA, Thompson SM, Callstrom MR, Young WF, Grant CS, Farley DR et al. Biopsy of pheochromocytomas and paragangliomas: Potential for disaster. Surgery. 2009 Dec;146(6):1158-1166. https://doi.org/10.1016/j.surg.2009.09.013
Vanderveen, Kimberly A. ; Thompson, Scott M. ; Callstrom, Matthew R. ; Young, William F. ; Grant, Clive S. ; Farley, David R. ; Richards, Melanie L. ; Thompson, Geoffrey B. / Biopsy of pheochromocytomas and paragangliomas : Potential for disaster. In: Surgery. 2009 ; Vol. 146, No. 6. pp. 1158-1166.
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