{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:07:00Z","timestamp":1756339620609,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,5,16]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>A 63-year-old woman with multiple endocrine neoplasia type 2A (MEN2A) presented with recurrent spells of headaches, sweats and palpitations decades after right adrenalectomy for phaeochromocytoma, and total thyroidectomy for medullary thyroid cancer. She was hypertensive and in sinus rhythm. DOTA-TATE positron-emission tomography (PET) demonstrated a 12mm enhancing left adrenal incidentaloma. 24\u2009hours urine catecholamines, and multiple plasma metanephrine and normetanephrine measurements were all within normal reference ranges. Based on her symptoms and imaging findings, left adrenalectomy was performed and found a 40\u2009mm phaeochromocytoma. Her symptoms have since completely resolved and plasma metanephrine is now undetectable MEN2-associated phaeochromocytomas are often bilateral and may be metachronous. Patients at high risk of phaeochromocytoma who develop symptoms of catecholamine excess should be carefully evaluated even if plasma or urinary metanephrines are within the normal reference range. Biochemical reference ranges for metanephrines need to be adjusted accordingly in patients who have had prior unilateral total adrenalectomy.<\/jats:p>","DOI":"10.1136\/bcr-2019-234132","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T05:57:13Z","timestamp":1591941433000},"page":"e234132","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Biochemistry may be misleading in metachronous MEN2A-associated phaeochromocytoma following unilateral total adrenalectomy"],"prefix":"10.1136","volume":"13","author":[{"given":"Anthony-Joe","family":"Nassour","sequence":"first","affiliation":[{"name":"Endocrine Surgery, Royal North Shore Hospital School, Saint Leonards, New South Wales, Australia"},{"name":"General Surgery, Royal North Shore Hospital School, St Leonards, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Nylen","sequence":"additional","affiliation":[{"name":"Department of Breast and Endocrine Surgery, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Sywak","sequence":"additional","affiliation":[{"name":"Endocrine Surgery, Royal North Shore Hospital School, Saint Leonards, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roderick","family":"Clifton-Bligh","sequence":"additional","affiliation":[{"name":"Endocrinology, Royal North Shore Hospital School, Saint Leonards, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"key":"2025082712231469000_13.6.e234132.1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6823-4-2"},{"key":"2025082712231469000_13.6.e234132.2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3418"},{"key":"2025082712231469000_13.6.e234132.3","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1177\/0004563215620822","article-title":"Different values of urinary fractionated metanephrines after unilateral adrenalectomy for pheochromocytoma according to time intervals after surgery","volume":"54","author":"Cho","year":"2017","journal-title":"Ann Clin Biochem"},{"key":"2025082712231469000_13.6.e234132.4","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-1-45"},{"key":"2025082712231469000_13.6.e234132.5","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0335"},{"key":"2025082712231469000_13.6.e234132.6","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-0084"},{"key":"2025082712231469000_13.6.e234132.7","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-12-1106"},{"key":"2025082712231469000_13.6.e234132.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199311183292103"},{"key":"2025082712231469000_13.6.e234132.9","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/00000478-198004000-00003","article-title":"Differences between sporadic pheochromocytoma and pheochromocytoma in multiple endocrime neoplasia, type 2","volume":"4","author":"Webb","year":"1980","journal-title":"Am J Surg Pathol"},{"key":"2025082712231469000_13.6.e234132.10","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1653"},{"key":"2025082712231469000_13.6.e234132.11","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1046\/j.1365-2265.1998.3751208.x","article-title":"Differences between sporadic and multiple endocrine neoplasia type 2A phaeochromocytoma","volume":"48","author":"Pomares","year":"1998","journal-title":"Clin Endocrinol"},{"key":"2025082712231469000_13.6.e234132.12","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2014.224832"},{"key":"2025082712231469000_13.6.e234132.13","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498"},{"key":"2025082712231469000_13.6.e234132.14","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1097\/00000658-199306000-00001","article-title":"Management of pheochromocytomas in patients with multiple endocrine neoplasia type 2 syndromes","volume":"217","author":"Lairmore","year":"1993","journal-title":"Ann Surg"},{"key":"2025082712231469000_13.6.e234132.15","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.141.12.1199"},{"key":"2025082712231469000_13.6.e234132.16","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1470"},{"key":"2025082712231469000_13.6.e234132.17","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-007-9402-y"},{"key":"2025082712231469000_13.6.e234132.18","doi-asserted-by":"publisher","DOI":"10.1007\/s00104-011-2192-7"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-234132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:23:25Z","timestamp":1756322605000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-234132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":18,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6,11]]},"published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1136\/bcr-2019-234132"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-234132","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}