L.P. Kotelnikova1, G.G. Freynd1, A.N. Fedachuk2
1E.A. Vagner Perm State Medical University, Perm
2Order of Honor Perm Regional Clinical Hospital, Perm
Kotelnikova L.P. ― D. Sc. (Medicine), Professor, Head of the surgical department with the course of cardio-vascular surgery and invasive cardiology.
26 Petropavlovskaya Str., Perm, Russian Federation, 614000, tel. +7-902-835-69-65, e-mail: firstname.lastname@example.org
The aim of this study was to estimate the sensitivity of the Pheochromocytoma Adrenal Gland Scored Scale (PASS) to predict the malignancy potential of pheochromocytomas.
We operated 46 patients with chromaffin tissue tumors. The results of 44 morphological examination of pheochromocytomas using PASS were analyzed.
In 31 cases (70.45%) the score ranged from 0 to three (benign tumors), in 13 (29.55%) ― from four to ten (potentially malignant tumors). The long-term results of adrenalectomy were compared with the data of morphological study. According to the results of our study, the morphological score of the PASS scale has a high sensitivity (96.8%) with a total score from 0 to three. At higher scores, the sensitivity is reduced by six times and reaches only 15.4%. In half of these samples polymorphism of tumor cells, invasion of tumor cells into vessels and capsules, their diffuse growth and large nests were found. Our study supports that the sensitivity of the PASS scale for predicting chromaffin tumor metastasis in the long-term postoperative period with the number of scores from 0 to three is 96.8%, from four to ten ― 15.4%.
Five-year average survival rate was 87.1%: after adrenalectomy for pheochromocytomas with the scores on the PASS scale from 0 to 3 ― 96.2% and from 4 to 10 ― 80%. Five-year survival rate does not significantly depend on the sum of scores on the PASS scale.
Key words: pheochromоcytoma, adrenalectomy, morphology, malignancy criteria, long-term results.