Pheochromocytoma, multiple endocrine neoplasia type 2, and von hippel-lindau disease

To the Editor: The report by Neumann et al. (Nov. 18 issue)¹ underscores the importance of screening for hereditary disorders in patients with pheochromocytoma. The authors' determination, however, that 23 percent of unselected patients with pheochromocytoma had hereditary disease is a higher figure than that in any prior report, including one series not listed by the authors in which the figure was approximately 7 percent². The authors may be correct, but there could be an ascertainment bias, a possibility they suggested in a previous article in which they reported a high incidence of von Hippel-Lindau syndrome in the Freiburg.