Pitfalls in the diagnosis of pheochromocytoma: A case series and review of the literature

Abstract

Background: Pheochromocytomas (PC) are neuroendocrine catecholamine-releasing tumors, which arise from chromaffin cells in the adrenal medulla. The clinical presentation of PC depends mostly on the capacity of chromaffin cells to synthesize and release catecholamines, including noradrenaline, adrenaline, dopamine and others. In this case series, we present the pitfalls in the diagnosis and treatment of pheochromocytoma in which the clinical presentation and results of laboratory, radiologic, and nuclear investigations led to an incorrect diagnosis. Case presentation: From 2002 to 2013, seven patients who were misdiagnosed and had pitfalls during treatment were found among 30 patients with pheochromocytoma. We retrospectively reviewed all the medical records of the patients. The data recorded for these seven patients included general demographic data, medical history, symptoms, imaging and laboratory results, histologic interpretation of biopsy and final pathology, and morbidities or mortalities. Conclusion: Correct diagnosis and management of pheochromocytoma is clinically important because misdiagnosis leads to high morbidity and mortality secondary to hypertensive crisis. The critical interpretation of each diagnostic test, attentive review of functional examinations, anatomic imaging methods, and careful history taking is essential for a correct diagnosis.