| Objective: To improve the knowledge and the diagnostic level of small pheochromocytoma and paraganglioma(PPGL) through analysis of the clinical characteristics of small PPGL.Methods: Retrospectively analyzed the clinical data of 103 patients with PPGL between April 2011 and February 2016. All objects were divided into small PPGL group(diameter 3 cm or less) and larger PPGL group(> 3 cm in diameter) according to the maximum diameter measured by preoperative CT. The differences of clinical manifestations, plasma free metanephrines(MNs), features of CT and clinical conditions in perioperative period were compared between the two groups.Results: 21 cases were enrolled into small PPGL group, the average diameter of tumors were 2.39±0.67 cm. 82 cases were enrolled into larger PPGL, the average diameter of the tumors were 6.36±2.84 cm. The incidence of headache, palpitation, sweating, other clinical manifestations of PPGL and having two or more symptoms of the classic triad in small PPGL were lower than those in larger PPGL. And the proportion of no symptoms of the triad within small PPGL group was higher than that in larger PPGL group. But all the differences were not significant. The rate of utilization of α-adrenoceptor blocker and hydration before operation were significantly lower in small PPGL. The average of metanephrine in small PPGL was significantly lower than that in larger PPGL, so was normetanephrine. And the incidence of slightly elevated or normal of plasma free MNs in small PPGL was higher than that in larger PPGL. There were some similar features in CT scan between the two groups. All of PPGL exhibit a attenuation of more than 10 Hu on plain CT scan and most of PPGL had a attenuation value more than 20 Hu. Obvious enhancement were very common in both groups on enhanced CT.Conclusion: Small PPGLs are not rare. The clinical manifestations of them are ofen atypical. And many patients with the disease exhibited modestly elevated or normal levels of biochemical marker. Anatomical and functional imaging are useful to identify the disease. In particular, a comprehensive analysis of a variety of clinical data can reduce the missed diagnosis and treatment of small PPGL. |
