Table 1.
Presenting Characteristics, Preoperative Management, Surgery, and Long-Term Outcomes in Adult Patients With AMH and its Subgroups Compared With Adult Patients With PCCs Without AMH
| All AMHs (n = 19) | P Value vs PCCs | AMHs Without PCC (n = 7) | P Value vs PCCs | AMHs With PCC (n = 12) | P Value vs PCCs | PCCs Without AMH (n = 95) | |
|---|---|---|---|---|---|---|---|
| Age at presentation, y | 47.2 ± 15.1 | 0.058 | 52.9 ± 8.6 | 0.713 | 43.9 ± 17.4 | 0.032 | 55.2 ± 17.0 |
| Females, n (%) | 12 (63) | 0.450 | 5 (71) | 0.499 | 7 (58) | 0.762 | 48 (51) |
| PCC, n (%) | 12 (63) | <0.001 | 0 (0) | <0.001 | 12 (100) | 1 | 95 (100) |
| Concurrent cortical adenoma, n (%) | 5 (26) | <0.001 | 5 (71) | <0.001 | 12 (100) | 1 | 0 (0) |
| No adenoma, n (%) | 2 (11) | 0.026 | 2 (29) | <0.001 | 0 (0) | 1 | 0 (0) |
| MEN2A/NF1, n (%) | 11 (9/2, 58) | <0.001 | 2 (2/0, 29) | 0.070 | 9 (7/2, 75) | <0.001 | 4 (1/3, 4) |
| Tumor size,a mm | 21.5 (20–40) | <0.001 | 28 (16–45) | 0.074 | 21.4 (20–40) | 0.002 | 49 (35–63) |
| U-A/P-MNE, × ULN | 2.3 (0.9–6.4) | 0.220 | 0.7 (0.4–1.2) | <0.001 | 4.1 (2.5–16.8) | 0.331 | 3.4 (1.3–15.0) |
| U-NA/P-NMNE, × ULN | 1.2 (0.7–3.1) | <0.001 | 1.1 (0.5–1.3) | <0.001 | 1.5 (0.9–3.6) | <0.001 | 7.9 (3.2–18.3) |
| Highest level, × ULN | 2.5 (1.4–7.0) | <0.001 | 1.2 (0.7–1.8) | <0.001 | 4.1 (2.0–16.8) | 0.039 | 13.5 (5.1–26.8) |
| Post-DST, mmol/L | 59 (30–440) | 0.048 | 70 (44–539) | 0.045 | 32 (30–40) | 0.943 | 30 (27–37) |
| Doxazosin dose preoperative, mg | 12 (0–23) | 0.021 | 0 (0–0) | <0.001 | 22 (20–32) | 0.956 | 24 (16–36) |
| Phenoxybenzamine dose preoperative, mg | 80 (50–88) | 0.158 | 50 (50–50) | 0.823 | 80 (73–148) | 0.055 | 50 (40–68) |
| No alpha-blockage, n (%) | 5 (26) | 0.006 | 5 (71) | <0.001 | 0 (0) | 1 | 4 (4) |
| Days on alpha-blockage prior to surgery | 30 (0–60) | 0.004 | 0 (0–5) | <0.001 | 37 (30–62) | 0.232 | 60 (33–90) |
| Surgery, n (%) | 19 (100) | 1 | 7 (100) | 0.495 | 12 (100) | 1 | 92 (97)b |
| Laparoscopic, n (%) | 13 (68) | 0.990 | 5 (71) | 1 | 8 (67) | 0.740 | 66/92 (72) |
| Converted to open, n (%) | 2/13 (15) | 0.637 | 1/5 (20) | 0.499 | 1/8 (13) | 1 | 7/59 (12) |
| Complications, n (%) | 1 (5) | 0.187 | 0 (0) | 0.338 | 1 (8) | 1 | 18/92 (20) |
| LOS postoperative, d | 5 (2–8) | 0.824 | 5 (2–7) | 0.418 | 5.5 (2.5–9.5) | 0.757 | 4 (3–8) |
| Follow-up, y | 11.2 ± 9.4 | 0.437 | 11.5 ± 10.5 | 0.553 | 11.1 ± 9.2 | 0.556 | 9.7 ± 7.1 |
| New PCC, n (%) | 6 (32) | <0.001 | 0 (0) | 0.649 | 6 (50) | <0.001 | 4 (4) |
| Metastasis, n (%) | 0 (0) | 0.588 | 0 (0) | 1 | 0 (0) | 1 | 5 (5) |
| Dead, n (%) | 2 (11) | 1 | 0 (0) | 0.645 | 2 (17) | 1 | 13 (14) |
Boldface indicates P < 0.05; italics indicate P = 0.05–0.09.
Abbreviations: Highest level, highest U-adrenaline/P-metanephrine/U-noradrenaline/P-normetanephrine level divided the ULN; LOS postoperative, number of days admitted in hospital after surgery; NA, not applicable; P, plasma; Post-DST, serum cortisol level post 1-mg DST (i.e., at 8 AM the next morning); U, urinary; U-A/P-MNE, highest U-adrenaline or P-metanephrine level divided the upper level of normal (ULN); U-NA/P-NMNE, highest U-noradrenaline or P-normetanephrine level divided the ULN.
Tumor size of the PCC or concurrent cortical tumor.
One patient declined due to old age, one patient due to separate extensive adenocarcinoma, and one patient died prior to surgery due to multiple myeloma.