Feocromocitoma-Paraganglioma: revisión de tema

  • Alejandro Román-González Hospital San Vicente Fundación
  • Juliana Sierra-Zuluaga Universidad de Antioquia
  • Johnayro Gutiérrez-Restrepo Hospital Pablo Tobón Uribe, Universidad de Antioquia
  • Carlos A. Builes-Barrera Hospital San Vicente Fundación, Universidad de Antioquia
  • Camilo Jiménez-Vásquez The University of Texas, MD Anderson Cancer Center
Palabras clave: paraganglioma, feocromocitoma, carcinoma neuroendocrino, metanefrina, catecolaminas.

Resumen

El feocromocitoma es una enfermedad poco frecuente, correspondiente a un tumor derivado de las células cromafines, originado en la médula de la glándula suprarrenal. Cuando este tumor se origina en los paraganglios el término correcto es paraganglioma. Las manifestaciones clínicas son variables y secundarias a la masa tumoral o a la producción exagerada de catecolaminas. Los síntomas originados por el crecimiento de la masa tumoral incluyen dolor abdominal, malestar epigástrico, obstrucción de estructuras cercanas como la vía biliar y los uréteres, y, cuando está localizado en otros sitios como el mediastino, disnea. Los síntomas secundarios a la hiperproducción de catecolaminas son diaforesis, palpitaciones, cefalea, crisis hipertensivas, hipertensión sostenida, constipación, náuseas, vómito y, en la forma más exagerada, crisis catecolaminérgicas. El diagnóstico se realiza mediante la medición de metanefrinas libres en orina de 24 horas o en plasma, y como alternativa se puede realizar medición de catecolaminas en orina de 24 horas. La medición de ácido vanilmandélico es poco sensible, lo mismo que la medición de catecolaminas en plasma, la cual no es recomendada. El tratamiento de esta enfermedad es quirúrgico. En aquellos pacientes con feocromocitoma maligno o paraganglioma se puede realizar una estrategia de observación activa y en quienes tengan progresión de la enfermedad el uso de quimioterapia o, según el grado de compromiso, el uso de metayodobencilguanidina marcada con yodo-131 es la terapia de elección. El uso de terapia molecular diana utilizando inhibidores de tirosina quinasa es un área de investigación activa.

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Biografía del autor/a

Alejandro Román-González, Hospital San Vicente Fundación

Médico, Internista, Endocrinólogo. Departamento de Endocrinología y Diabetes. Hospital Universitario San Vicente Fundación. Medellín, Colombia.

Juliana Sierra-Zuluaga, Universidad de Antioquia

Médica, Internista, residente de Endocrinología, Universidad de Antioquia. Medellín, Colombia.

Johnayro Gutiérrez-Restrepo, Hospital Pablo Tobón Uribe, Universidad de Antioquia

Médico, Internista, Endocrinólogo, Hospital Pablo Tobón Uribe. Profesor sección Endocrinología y Diabetes, Departamento de Medicina Interna, Universidad de Antioquia. Medellín, Colombia.

Carlos A. Builes-Barrera, Hospital San Vicente Fundación, Universidad de Antioquia

Médico, Internista, Endocrinólogo. Departamento de Endocrinología y Diabetes. Hospital Universitario San Vicente Fundación. Profesor sección Endocrinología y Diabetes, Departamento de Medicina Interna, Universidad de Antioquia. Medellín, Colombia.

Camilo Jiménez-Vásquez, The University of Texas, MD Anderson Cancer Center

Médico, Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center. Houston, Texas, Estados Unidos.

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Cómo citar
1.
Román-González A, Sierra-Zuluaga J, Gutiérrez-Restrepo J, Builes-Barrera CA, Jiménez-Vásquez C. Feocromocitoma-Paraganglioma: revisión de tema. Med. Lab. [Internet]. 1 de marzo de 2015 [citado 22 de abril de 2021];21(3-4):111-30. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/115
Publicado
2015-03-01
Sección
La Clínica y el Laboratorio
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