Skip to main content

Advertisement

Log in

Adrenal venous catecholamine concentrations in patients with adrenal masses other than pheochromocytoma

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

The aim of this study was to retrospectively examine adrenal venous catecholamine concentrations and related indices in non-pheochromocytoma patients and to estimate from the obtained results whether measurements of adrenal venous catecholamine concentrations by adrenal venous sampling (AVS) are useful for localizing adrenal pheochromocytoma. The study population comprised 15 patients in whom AVS was performed for evaluation of adrenal non-pheochromocytoma masses (primary aldosteronism, n = 8; Cushing syndrome, n = 5; non-hyperfunctioning tumor, n = 2) without hormonal intervention and was successful in bilaterally judging adrenal vein to infra-renal inferior vena cava cortisol ratios as >3.0. Wide ranges of catecholamine concentrations were seen for both right (epinephrine, 35–175,821 pg/ml; norepinephrine, 115–32,102 pg/ml; dopamine, 9–232 pg/ml) and left (epinephrine, 16–27,251 pg/ml; norepinephrine, 155–9,267 pg/ml; dopamine, 5–234 pg/ml) adrenal veins. High- to low-side adrenal vein concentration ratios also showed wide ranges of up to 779 for epinephrine, 22.5 for norepinephrine, and 7.8 for dopamine. Adrenal venous catecholamine concentrations obtained by AVS and simple comparisons between bilateral adrenal veins might not be useful to localize adrenal pheochromocytoma, as wide variations in concentrations and high- to low-side adrenal vein concentration ratios were noted in patients with adrenal non-pheochromocytoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. E.L. Bravo, R. Tagle, Pheochromocytoma: state-of-the-art and future prospects. Endocr. Rev. 24, 539–553 (2003)

    Article  PubMed  CAS  Google Scholar 

  2. W.F. Young Jr., Clinical practice. The incidentally discovered adrenal mass. N. Engl. J. Med. 356, 601–610 (2007)

    Article  PubMed  CAS  Google Scholar 

  3. A. Comlekci, S. Yener, S. Ertilav, M. Secil, B. Akinci, T. Demir, L. Kebapcilar, L. Kebacilar, F. Bayraktar, S. Yesil, S. Eraslam, Adrenal incidentaloma, clinical, metabolic, follow-up aspects: single centre experience. Endocrinology 37, 40–47 (2011)

    Google Scholar 

  4. D. Ye, E.Q. Dong, X. Lu, Z. Zang, Y. Feng, C. Li, The incidentally discovered adrenal mass. Endocrinology 42, 174–181 (2012)

    CAS  Google Scholar 

  5. M.A. Blake, C.G. Cronin, G.W. Boland, Adrenal imaging. Am. J. Roentgenol. 194, 1450–1460 (2010)

    Article  Google Scholar 

  6. A.F. Jacobson, H. Dend, J. Lombard, H.J. Lessig, R.R. Black, 123I-meta-iodobenzylguanidine scintigraphy for the detection of neuroblastoma and pheochromocytoma: results of a meta-analysis. J. Clin. Endocrinol. Metab. 95, 2596–2606 (2010)

    Article  PubMed  CAS  Google Scholar 

  7. R. Yu, N.N. Nissen, P. Chopra, D. Dhall, E. Phillips, M. Wei, Diagnosis and treatment of pheochromocytoma in an academic hospital from 1997 to 2007. Am. J. Med. 122, 85–95 (2009)

    Article  PubMed  Google Scholar 

  8. D.H. Jones, D.J. Allison, C.A. Hamilton, J.L. Reid, Selective venous sampling in the diagnosis and localization of pheochromocytoma. Clin. Endocrinol. (Oxf) 10, 179–186 (1979)

    Article  CAS  Google Scholar 

  9. R.A. Davies, N.L. Patt, M.J. Sole, Localization of pheochromocytoma by selective venous catheterization and assay of plasma catecholamines. Can. Med. Assoc. J. 120, 539–542 (1979)

    PubMed  CAS  Google Scholar 

  10. M.J. Brown, D.J. Allison, D.A. Jenner, P.J. Lewis, C.T. Dollery, Increased sensitivity and accuracy of pheochromocytoma diagnosis achieved by use of plasma-adrenaline estimations and a pentolinium-suppression test. Lancet 1(8213), 174–177 (1981)

    Article  PubMed  CAS  Google Scholar 

  11. D.J. Allison, M.J. Brown, D.H. Jones, J.B. Timmis, Role of venous sampling in locating a pheochromocytoma. Br. Med. J. 286, 1122–1124 (1983)

    Article  CAS  Google Scholar 

  12. G. Kahaly, U. Krause, H. Ritthaler, U. Cordes, R. Gunther, J. Schrezenmeir, J. Beyer, Selective blood sampling in adrenal hypertension. Cardiology 72(Suppl 1), 179–181 (1985)

    Article  PubMed  Google Scholar 

  13. P. Collste, B. Brismar, A. Alveryd, I. Björkhem, C. Hårdstedt, L. Svensson, J. Ostman, The catecholamine concentration in central veins of hypertensive patients—an aid not without problems in locating pheochromocytoma. Acta Chir Scand Suppl. 530, 67–71 (1986)

    PubMed  CAS  Google Scholar 

  14. E.M. Freel, A.W. Stanson, G.B. Thompson, C.S. Grant, D.R. Farley, M.L. Richards, W.F. Young Jr., Adrenal venous sampling for catecholamines: a normal study. J. Clin. Endocrinol. Metab. 95, 1328–1332 (2010)

    Article  PubMed  CAS  Google Scholar 

  15. J.W. Funder, R.M. Carey, C. Fardella, C.E. Gomez-Sanchez, F. Mantero, M. Stowasser, W.F. Young Jr., V.M. Montori, Endocrine society. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 93, 3266–3281 (2008)

    Article  PubMed  CAS  Google Scholar 

  16. H. Hokotate, H. Inoue, Y. Baba, S. Tsuchimochi, M. Nakajo, Aldosteronomas: experience with superselective adrenal arterial embolization in 33 patients. Radiology 227, 401–406 (2003)

    Article  PubMed  Google Scholar 

  17. C.D. Forster, I.A. Macdonald, The assay of the catecholamine content of small volumes of human plasma. Biomed. Chromatol. 13, 209–215 (1999)

    Article  CAS  Google Scholar 

  18. W.F. Young Jr., A.W. Stanson, G.B. Thompson, C.S. Grant, D.R. Farley, J.A. van Heerden, Role for adrenal venous sampling in primary aldosteronism. Surgery 136, 1227–1235 (2004)

    Article  PubMed  Google Scholar 

  19. W.F. Young Jr., H. du Plessis, G.B. Tompson, C.S. Grant, D.R. Farley, M.L. Richards, D. Erickson, A. Vella, A.W. Stanson, J.A. Carney, C.F. Abboud, P.C. Carpenter, The clinical conundrum of corticotropin-independent autonomous cortisol secretion in patients with bilateral adrenal masses. World J. Surg. 32, 856–862 (2008)

    Article  PubMed  Google Scholar 

  20. P.E. Cryer, Physiology and pathophysiology of the human sympathoadrenal neuroendocrine system. N. Engl. J. Med. 303, 436–444 (1980)

    Article  PubMed  CAS  Google Scholar 

  21. J. Wortsman, S. Frank, P.E. Cryer, Adrenomedullary response to maximal stress in humans. Am. J. Med. 77, 779–784 (1984)

    Article  PubMed  CAS  Google Scholar 

  22. D. Miotto, R. De Toni, G. Pitter, T.M. Seccia, R. Motta, M. Vincenzi, G. Feltrin, G.P. Rossi, Impact of accessory hepatic veins on adrenal vein sampling for identification of surgically curable primary aldosteronism. Hypertension 54, 885–889 (2009)

    Article  PubMed  CAS  Google Scholar 

  23. H. Suga, A. Inagaki, K. Ota, S. Taguchi, T. Kato, S. Kakiya, T. Itatsu, K. Yokoi, T. Tsuzuki, Adrenal pseudocyst mimicking a pheochromocytoma found after a traffic accident. Intern. Med. 42, 66–71 (2003)

    Article  PubMed  Google Scholar 

  24. D. Miotto, R. De Toni, G. Pitter, T.M. Seccia, R. Motta, M. Vincenzi, G. Feltrin, G.P. Rossi, Impact of accessory hepatic veins on adrenal vein sampling for identification of surgically curable primary aldosteronism. Hypertension 54(4), 885–889 (2009)

    Article  PubMed  CAS  Google Scholar 

  25. M.G. Ziegler, X. Bao, B.P. Kennedy, A. Joyner, R. Enns, Location, development, control, and function of extra-adrenal phenylethanolamine N-methyltransferase. Ann. NY Acad Sci. 971, 76–82 (2002)

    Article  PubMed  CAS  Google Scholar 

  26. C. Ricordi, S.D. Shah, P.E. Lacy, W.E. Clutter, P.E. Cryer, Delayed extra-adrenal epinephrine secretion after bilateral adrenalectomy in rats. Am. J. Physiol. 254, E52–E53 (1988)

    PubMed  CAS  Google Scholar 

  27. E.C. Newbould, G.A. Ross, J.E. Dacie, P.M. Bouloux, G.M. Besser, A. Grossman, The use of venous catheterization in the diagnosis and localization of bilateral pheochromocytomas. Clin. Endocrinol. (Oxf) 35, 55–59 (1991)

    Article  CAS  Google Scholar 

  28. S.L. Chew, J.E. Dacie, R.H. Reznek, E.C. Newbould, R. Sheaves, P.J. Trainer, D.G. Lowe, W.S. Shand, Bilateral pheochromocytomas in von Hippel-Lindau disease: diagnosis by adrenal vein sampling and catecholamine assay. Q. J. Med. 87, 49–54 (1994)

    PubMed  CAS  Google Scholar 

  29. C.S. Connor, A.S. Hermreck, J.H. Thomas, Pitfalls in the diagnosis of pheochromocytoma. Am. Surg. 54, 634–636 (1988)

    PubMed  CAS  Google Scholar 

  30. K. Pacak, D.S. Goldstein, J.L. Doppman, B.L. Shulkin, R. Udelsman, G. Eisenhofer, A “pheo” lurks: novel approaches for locating occult pheochromocytoma. J. Clin. Endocrinol. Metab. 86, 3641–3646 (2001)

    Article  PubMed  CAS  Google Scholar 

  31. R. Därr, G. Eisenhofer, J. Kotzerke, K. Zöphel, C. Stroszczynski, J. Deinum, L.J. Schultze Kool, S. Pistorius, H. Neumann, S.R. Bornstein, L.C. Hofbauer, Is there still a place for adrenal venous sampling in the diagnostic localization of pheochromocytoma? Endocrine 40, 75–79 (2011)

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

No grants and no conflicts of interest are reported for this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yasutaka Baba.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baba, Y., Nakajo, M. & Hayashi, S. Adrenal venous catecholamine concentrations in patients with adrenal masses other than pheochromocytoma. Endocrine 43, 219–224 (2013). https://doi.org/10.1007/s12020-012-9792-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-012-9792-y

Keywords

Navigation