Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2017

01-05-2017 | Endocrine Tumors

Resection of Pheochromocytoma Improves Diabetes Mellitus in the Majority of Patients

Authors: Toni Beninato, MD, Wouter P. Kluijfhout, MSc, Frederick Thurston Drake, MD, James Lim, BA, Julie S. Kwon, BA, Maggie Xiong, BA, Wen T. Shen, MD, Jessica E. Gosnell, MD, Chienying Liu, MD, Insoo Suh, MD, Quan-Yang Duh, MD

Published in: Annals of Surgical Oncology | Issue 5/2017

Login to get access

Abstract

Background

Catecholamine excess in patients with pheochromocytoma often results in impaired glucose tolerance, leading to diabetes mellitus. Little data are available on the long-term effect of surgery on diabetes.

Objective

The primary aim of this study was to determine the likelihood of diabetes cure after surgery, while secondary objectives were to determine risk factors for development of diabetes preoperatively and persistence of diabetes postoperatively.

Methods

All patients undergoing surgery for pheochromocytoma from 1996 to 2015 were retrospectively reviewed to identify those with a preoperative diagnosis of diabetes. Demographic and diabetes-specific data were collected. Median follow-up was 52.1 months.

Results

Overall, 153 patients underwent surgery. Diabetes was seen in 36 (23.4%) patients. Eight patients met the exclusion criteria and were removed from the final analysis, while 22 (78.6%) patients had complete resolution of diabetes. Four patients remained on medication with improved control. Overall, 93.0% of patients had improvement of their diabetes; two patients did not improve. Patients with large, symptomatic tumors were more likely to develop preoperative diabetes, and diabetes was more likely to persist in patients who had an elevated body mass index (BMI).

Conclusions

Diabetes was found concurrently with pheochromocytoma in 23% of patients, more often in those with large, symptomatic tumors. The majority of patients had long-term resolution of diabetes after successful resection; however, some patients may continue to require treatment of diabetes after operation, especially those with a higher BMI.
Literature
1.
Lenders JWM, Duh Q-Y, Eisenhofer G, et al. Pheochromocytoma and paraganglioma: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(6):1915–42.CrossRefPubMed
2.
Bluher M, Windgassen M, Paschke R. Improvement of insulin sensitivity after adenalectomy in patients with pheochromocytoma. Diabetes Care. 2000;23(10):1591.CrossRefPubMed
3.
Douma S, Petidis K, Kartali N, et al. Pheochromocytoma presenting as diabetic ketoacidosis. J Diabetes Complic. 2008;22(4):295–6.CrossRef
4.
Martin JF, Martin LN, Yugar-Toledo JC, et al. Coronary emergency and diabetes as manifestations of pheochromocytoma. Int J Cardiol. 2010;139(3):e39–41.CrossRefPubMed
5.
La Batide-Alanore A, Chatellier G, Plouin P-F. Diabetes as a marker of pheochromocytoma in hypertensive patients. J Hypertens. 2003;21(9):1703–7.CrossRefPubMed
6.
Chen Y, Hodin RA, Pandolfi C, Ruan DT, McKenzie TJ. Hypoglycemia after resection of pheochromocytoma. Surgery. 2014;156(6):1404–8.CrossRefPubMed
7.
Wiesner TD, Blüher M, Windgassen M, Paschke R. Improvement of insulin sensitivity after adrenalectomy in patients with pheochromocytoma. J Clin Endocrinol Metab. 2003;88(8):3632–6.CrossRefPubMed
8.
Chamberlain JJ, Rhinehart AS, Shaefer CF Jr, Neuman A. Diagnosis and management of diabetes: synopsis of the 2016 american diabetes association standards of medical care in diabetes guideline development and evidence grading. Ann Intern Med. 2016;164:542–52CrossRefPubMed
9.
Stenstrom G, Sjostrom L, Smith U. Diabetes mellitus in phaeochromocytoma: fasting blood glucose levels before and after surgery in 60 patients with phaeochromocytoma. Acta Endocrinol (Copenh). 1984;106:511–5.PubMed
10.
Pogorzelski R, Toutounchi S, Krajewska E, et al. The effect of surgical treatment of phaeochromocytoma on concomitant arterial hypertension and diabetes mellitus in a single-centre retrospective study. Cent Eur J Urol. 2014;67(4):361–5.
11.
Mokdad AH, Bowman BA, Ford ES, et al. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001;286(10):1195–2000.CrossRefPubMed
Metadata
Title
Resection of Pheochromocytoma Improves Diabetes Mellitus in the Majority of Patients
Authors
Toni Beninato, MD
Wouter P. Kluijfhout, MSc
Frederick Thurston Drake, MD
James Lim, BA
Julie S. Kwon, BA
Maggie Xiong, BA
Wen T. Shen, MD
Jessica E. Gosnell, MD
Chienying Liu, MD
Insoo Suh, MD
Quan-Yang Duh, MD
Publication date
01-05-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 5/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5701-6

Other articles of this Issue 5/2017

Annals of Surgical Oncology 5/2017 Go to the issue

Endocrine Tumors

American Joint Committee on Cancer: Endocrine Surgery

Bone and Soft Tissue Sarcomas

Preoperative Chemotherapy and Survival for Large Anorectal Gastrointestinal Stromal Tumors: A National Analysis of 333 Cases

Gynecologic Oncology

Neoadjuvant Chemotherapy Increases R0 Cytoreduction Rate But Does Not Improve Final Outcome in Advanced Epithelial Ovarian Cancer

Pancreatic Tumors

Analysis of Predictors of Resection and Survival in Locally Advanced Stage III Pancreatic Cancer: Does the Nature of Chemotherapy Regimen Influence Outcomes?

Breast Oncology

Reliability of the Ki67-Labelling Index in Core Needle Biopsies of Luminal Breast Cancers is Unaffected by Biopsy Volume

Colorectal Cancer

Prognostic Value of Sterilized Lymph Nodes After Preoperative Chemoradiotherapy for Patients with ypN0 Rectal Cancer