SAT594 Thyroid Dysfunction Is Very Common In Patients With Pheochromocytoma And Paraganglioma: A Cross-sectional Study

Abstract

Abstract Disclosure: C. Ramirez-Renteria: Speaker; Self; Ipsen. M. Garcia-Saenz: None. N. Morin-Martinez: None. A. Albarran-Sanchez: None. Background: Thyroid function abnormalities are reported in 8-9% of the general population, but the prevalence may change according to different ages, populations, iodine intake, etc. Preoperatory evaluations for pheochromocytoma (Pheo) and paragangliomas (PGN) don’t include routine thyroid function tests, but uncontrolled hypo- or hyperthyroidism may result in adverse effects outcomes during surgery. Aim: to describe the frequency of thyroid function abnormalities in patients evaluated for Pheo and PGN in a referral center. Materials and Methods: All the medical files of adult patients evaluated for Pheo or PGN between January 2018 and December 2022 were reviewed. The available clinical, biochemical, imaging, and pathology data confirming the diagnosis were retrieved. We determined the frequency of patients with a previous diagnosis of thyroid disease, type of disease, and date of diagnosis and recorded the data of patients without a diagnosis but that had their thyroid function tested during the perioperative evaluation. Results: 359 patients with Pheo/PGN were evaluated, 72.7% had a neck PGN, 88% were women and the median age at diagnosis was 56.5 years (IQR 45-66), thyroid function tests were performed in 51.3%, and only 22.8% were normal, 20.9% had primary hypothyroidism, 3.9% had hypothyroidism after a procedure, 2.5% had hyperthyroidism, and 1.1% had thyroiditis. The patients with neck PGN were the most likely to present with hypothyroidism (p=0.006) and they were also the most likely to have hypothyroidism during follow-up, Abnormal thyroid images were found in 19.2%. Thyroid dysfunction was detected before the tumor in 21.5%, during the evaluation of the tumor in 25.8%, and after in 52.7%. Hypertensive cardiomyopathy was more common in patients with abnormal thyroid function (OR 1.969, CI 95% 1.052-3.685, p=0.032), as well as cardiomegaly (OR 2.145, CI 95% 1.200-3.835) and hypertension (OR 1.937, CI95% 1.269-2.956). Conclusions: Pheo/PGN are frequently associated with thyroid dysfunction. Heart disease and hypertension are more common in patients with both comorbidities. Thyroid function tests are suggested during perioperative evaluation in patients with a history of thyroid disease, thyroid abnormalities in imaging, poor blood pressure control, or heart disease. Thyroid function may require an additional evaluation in some cases during the follow-up of Pheo/Para. Presentation: Saturday, June 17, 2023