Chromogranin A as an early biological marker of malignant pheochromocytoma recurrence

We report the case of a 56-years old woman, with a sporadic isolated norepinephrine-secreting right adrenal pheochromocytoma, revealed by abdominal pain, fever and loss of weight. Surgical resection was macroscopically complete, but some anatomical features were malignant. Follow-up was performed using urinary catecholamine and derivatives, plasmatic chromogranin A level and 131I-mIBG scintigraphy. After complete normalisation of all parameters, chromogranin A levels increased again and locoregional recurrence and metastases were revealed. After anti-depressive drug which decreased the mIBG uptake was suppressed, the uptake of 131I-mIBG by the lesions allowed palliative radio-metabolic treatment. (authors)