{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:56:11Z","timestamp":1785297371751,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp; Metabol"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>We sought to characterize the prevalence and factors characteristic of head and neck paragangliomas (HNPGLs) that secrete catecholamines to inform best practices for diagnosis and management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study from 2000 to 2020 at a single\u2010institution tertiary centre. One\u2010hundred fifty\u2010two patients (182 tumours) with HNPGLs with at least one measurement of urine or plasma catecholamines and\/or catecholamine metabolite levels prior to treatment were included. We differentiated and characterized those patients with increased level(s) of any nature and those with \u2018clinically significant\u2019 versus \u2018clinically insignificant\u2019 catecholamine production.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010one (20.4%) patients had increased catecholamine and\/or catecholamine metabolite levels. In most patients, these levels were \u22645\u2010fold above the upper limit of the reference range. Four of these 31 patients with increased levels were ultimately found to have an additional catecholamine secreting mediastinal paraganglioma or pheochromocytoma. Fourteen of 31 patients with HNPGL were deemed clinically significant secretors of catecholamines based on hyper\u2010adrenergic symptoms and\/or profound levels of normetanephrines. This cohort was enriched for patients with paragangliomas of the carotid body or cervical sympathetic chain and those with <jats:italic>SDHB<\/jats:italic> genetic mutations. Ultimately, the prevalence of clinically significant catecholamine secreting Hangs was determined to be 9.2% and 7.7% based on a per\u2010patient and per\u2010tumour basis, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The rate of catecholamine excess in the current cohort of patients with HNPGLs was higher than previously reported. Neuroendocrine tumours of any anatomic subsite may secrete catecholamines, although not all increased laboratory level(s) are indicative of clinically significant catecholamine secretion causing symptoms or warranting adrenergic blockade.<\/jats:p><\/jats:sec>","DOI":"10.1002\/edm2.256","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T08:26:50Z","timestamp":1622795210000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Re\u2010evaluating the prevalence and factors characteristic of catecholamine secreting head and neck paragangliomas"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2076-7589","authenticated-orcid":false,"given":"Joshua D.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Michigan Medical School Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Ellsperman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Michigan Medical School Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Basura","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Michigan Medical School Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Else","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrine, and Diabetes Department of Internal Medicine University of Michigan Medical School Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-017-0786-1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1224771"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198408000-00002"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.11.8034"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-1632"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-15-0221"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820938660"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.122"},{"key":"e_1_2_9_11_1","volume-title":"Clinical Test Catalog","author":"The University of Michigan Department of Pathology","year":"2020"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.11.1427"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13284"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-0396"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489420931540"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-007-9360-4"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113947"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-09-0172"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP11058.OR"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2014-1026"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2010.153320"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2013.07.032"},{"key":"e_1_2_9_23_1","volume-title":"Endotext [Internet]","author":"Pacak K","year":"2000"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2004.02.007"}],"container-title":["Endocrinology, Diabetes &amp; 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