Constantinescu G, Langton K, Conrad C, et al. - This multicenter cross-sectional study was undertaken to determine if patients with pheochromocytoma and paraganglioma (PPGL) have altered steroid production vs patients with primary hypertension. The sample consisted of 182 patients with pheochromocytoma, 36 with paraganglioma, and 270 patients with primary hypertension. For additional comparisons, patients with primary aldosteronism (n = 461) and Cushing syndrome (n = 124) were included. Compared with patients with primary hypertension, those with pheochromocytoma had higher circulating concentrations of cortisol, 11-deoxycortisol, 11-deoxycorticosterone, and corticosterone. In addition, concentrations of cortisol, 11-deoxycortisol, and corticosterone were higher in patients with pheochromocytoma compared with paraganglioma. This is the first major study in patients with PPGLs that supports the concept of adrenal cortical-medullar interactions involving the influence of catecholamines on adrenal steroids in a clinical setting. Such results may have implications for PPGL's cardiovascular complications and for tumor patient clinical management.