Incidental pheochromocytoma: fifteen-year experience at a community hospital.

BACKGROUND: Pheochromocytoma is a well-recognized neuroendocrine tumor. Classical symptoms are well described, but recent studies have suggested that many patients are diagnosed incidentally. No studies have evaluated incidental pheochromocytoma with respect to year of diagnosis. METHODS: A retrospective study was performed from January 1992-November 2006 to evaluate the frequency of incidental pheochromocytoma. Patients were included if pathological specimens were available. RESULTS: 21 patients were included. 15/21 (71.4%) cases were incidentally discovered. 11/15 (73.3%) were diagnosed after 2000, while 4/15 (26.7%) were diagnosed before 2000. 15/21 (71.4%) patients had hypertension, and all 6 patients without hypertension had pheochromocytoma diagnosed incidentally. Only 3/21 (14.3%) patients were diagnosed by biochemical testing. DISCUSSION: This observational study suggests an increasing number of incidental pheochromocytomas. Several possibilities for this observation include increased usage of imaging studies, decreased use of biochemical testing, and an increase in referring patients to surgeons for resection without an appropriate endocrine work-up. Referring physicians and surgeons alike should take note of this.

"Where obesity goes, so goes diabetes"--dual epidemics of alarming proportions.

Diabetes and obesity are increasing in alarming, epidemic proportions not only in West Virginia, but also in the United States and in the world. Their combined toll encompasses not only an increased risk of premature cardiovascular disease and death, but multiple other associated co-morbidities. Recognition of their impact on healthcare systems is crucial and involves awareness and action on the part of providers at every level. Education is of paramount importance in combating these growing trends with preservation of the health and well-being of the populace as an ultimate goal.