LETTER
Diagnosing Pheochromocytoma in von Hippel-Lindau Disease
Mumtaz A. Siddiqui
15 September 1994 | Volume 121 Issue 6 | Pages 465-466
TO THE EDITOR:
The report by Aprill and colleagues [1] stresses the importance of silent adrenal nodules and pheochromocytomas in Lindau disease. Computed tomographic (CT) scan appearance, although as variable as pheochromocytoma pathologic findings, is fairly accurate for diagnosis [2]. The report does not describe any features of the adrenal nodules. Also, there is a disparity between the nodule size shown in the CT scan and that shown by the surgical pathologic findings. In a tumor that is known for its well-encapsulated nature [3], this would indicate a false-positive CT scan of the "silent nodules." The only differentiation between a malignant and a benign pheochromocytoma is the presence of metastases, which commonly occur in the regional lymph nodes, bone, lung, pleural space, and liver [4].
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Author and Article Information
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The Graduate Hospital, Philadelphia, PA 19146
1. Aprill BS, Drake AJ III, Lasseter DH, Shakir KM. Silent adrenal nodules in von Hippel-Lindau disease suggest pheochromocytoma. Ann Intern Med. 1994; 120:485-7.
2. Dunnick NR, Schaner EG, Doppman JL, Strott CA, Gill JR, Javadpour N. Computed tomography in adrenal tumors. AJR Am J Roentgenol. 1979; 132:43-6.
3. Rossi J. Ackerman's Surgical Pathology. 7th ed. St. Louis: C. V. Mosby Company; 1989:806.
4. Mahoney EM, Harrison JH. Malignant pheochromocytoma. Clinical course and treatment. J Urol. 1977; 118:225-9.
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