Effectiveness and limits of preoperative imaging studies for the localisation of pheochromocytomas and paragangliomas: a review of 282 cases

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Abstract
Objective: To find out the optimal strategy for the preoperative location of pheochromocytomas and paragangliomas. Design: Retrospective study. Patients: 282 patients operated on for histologically confirmed pheochromocytoma in France between 1980 and 1991, the past decade. Main outcome measures: The results of imaging procedures, i.e. computed tomography (CT), 131I meta‐iodobenzylguanidine scintigraphy (MIBG) and magnetic resonance imaging (MRI) were reviewed. Results: Pheochromocytomas were sporadic in 206 (73%). They were unilateral in 189 (67%), bilateral in 54 (19%) and extra‐adrenal in 39 (14%). Overall sensitivity of the studies was 89% for CT, 98% for MRI, and 81% for 131I‐MIBG. In unilateral adrenal lesions sensitivity were 100% for CT and MRI, and 88% for 131I‐MIBG; in bilateral lesions 66% for CT, 100% for MRI, and 62% for 131I‐MIBG; in extra‐adrenal lesions 64% for CT, 88% for MRI, and 64% for 131I‐MIBG. Conclusion: The accuracy with which pheochromocytomas and paragangliomas can be visualized questions nowadays the routine use of abdominal approach. In selected cases of sporadic unilateral chromaffin tumours, a posterior, lateral, or even laparoscopic approach should be considered. Copyright © 1998 Taylor and Francis Ltd.

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