Revisiting Urinary Vanillylmandelic Acid in Pheochromocytoma: Insights from a 16-Year Tertiary Center Cohort
Öz
Background: This study aimed to evaluate the clinical, biochemical, and pathological characteristics of pheochromocytoma cases diagnosed at a tertiary center. Additionally, it investigated the diagnostic value of urinary catecholamines in predicting tumor size.
Methods: Sixty-six adult patients with histopathologically confirmed pheochromocytoma diagnosed between January 2008 and April 2024 were retrospectively analyzed. Demographic data, clinical symptoms, tumor size, and 24-hour urinary catecholamine levels were examined. Statistical analyses were performed using SPSS version 25.
Results: A total of 66 patients were included in the study; the mean age was 46.10 ± 15.84 years, and 62.1% were female. The most frequently reported symptoms were hypertension (71.4%), palpitations (46.0%), and headache (42.9%). Among patients with unifocal tumors, both VMA (p=0.001) and normetanephrine (p=0.039) levels were significantly higher in large tumors ≥4 cm compared to small tumors <4 cm. A VMA cutoff value of 6.61 mg/24h achieved 85.7% sensitivity and 70.6% specificity (AUC=0.807) in identifying large tumors.
Conclusions: Urinary VMA levels may serve as a useful biochemical marker for predicting tumor size in pheochromocytoma patients, particularly when plasma testing is not available. A structured diagnostic and follow-up process is necessary to achieve better outcomes in this rare but potentially life-threatening condition.
Anahtar Kelimeler
pheochromocytoma, catecholamines, vanillylmandelic acid, tumor size, genetic testing
Destekleyen Kurum
The authors received no financial support for the research and/or authorship of this article. No funding was received for this study.
Etik Beyan
Ethical approval was obtained from the Human Research Ethics Committee of Ankara University Faculty of Medicine (Decision No: i04-333- 24, dated 13.05.2024).
Teşekkür
The authors acknowledge the use of artificial intelligence for language
editing and improving the fluency and grammar of this manuscript. All scientific content, data analysis, interpretation, and conclusions remain entirely the work and responsibility of the authors.
Kaynakça
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