It is difficult to diagnose malignant
chromaffinoma among the endocrine
tumors. At present, using biochemical and histochemical methods,
tumors with the
estrogen or nonestrogen target organs have been proved to possess
estradiol receptors. In this paper, binding of
steroid to active
chromaffinoma was observed using synthesized 4-amino-N-fluorescent isothiocyanate-17 beta-
estradiol (4 NHEF) as a probe. Benign and malignant
chromaffinoma may be differentiated by the fluorescence difference. Under the same condition, the binding of fluorescence
estradiol to the normal adrenal cells was weak. It was stronger in the majority of benign
chromaffinoma, but was very strong in the malignant type. In a case of malignant
chromaffinoma, the adrenal was excised first which was diagnosed as a benign
tumor by pathological examination. But it was malignant by 4 NHEF
stain. After two days, the patient's blood pressure became elevated and a second operation had to be done. Still, the
tumor cells were benign by pathological examination. This
chromaffinoma was finally diagnosed by fluorescence labelled
estradiol which is more sensitive than pathology.