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Diagnosing Pheochromocytoma in von Hippel-Lindau Disease
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TO THE EDITOR:
The report by Aprill and colleagues [1] stresses the importance of silent adrenal nodules and pheochromocytomas in Lindau disease. Computed tomographic (CT) scan appearance, although as variable as pheochromocytoma pathologic findings, is fairly accurate for diagnosis [2]. The report does not describe any features of the adrenal nodules. Also, there is a disparity between the nodule size shown in the CT scan and that shown by the surgical pathologic findings. In a tumor that is known for its well-encapsulated nature [3], this would indicate a false-positive CT scan of the “silent nodules.” The only differentiation between a malignant and a benign pheochromocytoma is the presence of metastases, which commonly occur in the regional lymph nodes, bone, lung, pleural space, and liver [4].
Mumtaz A. Siddiqui
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
