091 - Chromogranin-A and adrenal incidentalomas: a role? which one?
Autore/i: L. Giovanella
Rivista: RIMeL - IJLaM, Vol. 6, N. 3-S1, 2010 (MAF Servizi srl ed.)
Pagina/e: 91-92
Adrenal incidentalomas are defined as asymptomatic adrenal masses occasionally discovered during high-resolution imaging procedures. The recommended case detection test is measurement of free plasma fractionated metanephrines. However, this test results in more false-positive tests than true positives, often leading to unnecessary tumor-localization attempts. Chromogranin A (CgA) is a member of the granin family contained in secretory vescicles of chromaffin adrenal cells. Serum CgA showed to be more accurate than urinary markers, including metanephrines, and was reported to be almost equivalent to the gold-standard plasma metanephrines assay by different authors. Because negative plasma fractionated metanephrines is highly predictive of the absence of pheochromocytoma, it is uncertain whether additional CgA testing should be added to the initial workup. However, optimal test performance was achieved when the recommended, definitively diagnostic, 4-fold elevation criterion for plasma fractionated metanephrines was supplemented with serum CgA measurement for those cases with lesser plasma fractionated metanephrines elevations.