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Diseases

Pheochromocytoma

OVERVIEW

  • Highlights & Basics
  • Images

DIAGNOSIS

  • Diagnostic Approach
  • Risk Factors
  • History & Exam
  • Tests
  • Differential Diagnosis
  • Criteria
  • Screening

TREATMENT

  • Tx Approach
  • Tx Options
  • Emerging Tx
  • Prevention

FOLLOW-UP

  • Overview
  • Complications

REFERENCES

  • Citations
  • Guidelines
  • Credits

PATIENT RESOURCES

  • Patient Instructions

Highlights & Basics

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Key Highlights
  • Pheochromocytoma is a rare neuroendocrine tumor of the adrenal glands. It can present with palpitations, diaphoresis, pallor, and paroxysmal hypertension.

  • Risk factors include multiple endocrine neoplasia type 2, Von Hippel-Lindau syndrome, and neurofibromatosis type 1.

  • Diagnosed by increased levels of metanephrines and normetanephrines.

  • Treatment includes medical therapy for hypertension and surgical excision of tumor (open or laparoscopic adrenalectomy). For unresectable tumors, alternative approaches include chemotherapy or radiopharmaceuticals.

  • Complications include hypertensive crisis, myocardial infarction, and hypotension.

Quick Reference

  • History & Exam

    • Key Factors

      • Other Factors

        More information...
      • Diagnostics Tests

          More information...
        • Treatment Options

            More information...

          Definition

          Epidemiology

          Etiology

          Pathophysiology

          content by BMJ Group
          Last updated

          Images

          • Abdominal CT scan with mass in the left adrenal gland, compatible with a pheochromocytoma

            Abdominal CT scan with mass in the left adrenal gland, compatible with a pheochromocytoma

          • Metaiodobenzylguanidine (MIBG) scintigraphy identified hyperfixation in the left adrenal gland compa

            Metaiodobenzylguanidine (MIBG) scintigraphy identified hyperfixation in the left adrenal gland compatible with pheochromocytoma

          • Left laparoscopic adrenalectomy: (A) macroscopic examination, 6 cm tumor; (B) microscopic examinatio

            Left laparoscopic adrenalectomy: (A) macroscopic examination, 6 cm tumor; (B) microscopic examination: neoplasm of the adrenal medulla with eosinophilic cytoplasm of large cells with positive fine granular chromogranin A; (C) round and oval nucleus and sustentacular cells S100+; (D) pheochromocytoma

          Citations

            Key Articles

            • Neumann HPH, Young WF Jr, Eng C. Pheochromocytoma and paraganglioma. N Engl J Med. 2019 Aug 8;381(6):552-65.[Abstract]

            • Fishbein L, Del Rivero J, Else T, et al. The North American Neuroendocrine Tumor Society consensus guidelines for surveillance and management of metastatic and/or unresectable pheochromocytoma and paraganglioma. Pancreas. 2021 Apr 1;50(4):469-93.[Abstract][Full Text]

            • National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors [internet publication].[Full Text]

            • Kunz PL, Reidy-Lagunes D, Anthony LB, et al; North American Neuroendocrine Tumor Society. Consensus guidelines for the management and treatment of neuroendocrine tumors. Pancreas. 2013 May;42(4):557-77.[Abstract][Full Text]

            • Plouin PF, Amar L, Dekkers OM, et al; Guideline Working Group. European Society of Endocrinology clinical practice guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma. Eur J Endocrinol. 2016 May;174(5):G1-10.[Abstract][Full Text]

            Referenced Articles

            • 1. Neumann HPH, Young WF Jr, Eng C. Pheochromocytoma and paraganglioma. N Engl J Med. 2019 Aug 8;381(6):552-65.[Abstract]

            • 2. Tevosian SG, Ghayee HK. Pheochromocytomas and paragangliomas. Endocrinol Metab Clin North Am. 2019 Dec;48(4):727-50.[Abstract]

            • 3. Martucci VL, Pacak K. Pheochromocytoma and paraganglioma: diagnosis, genetics, management, and treatment. Curr Probl Cancer. 2014 Jan-Feb;38(1):7-41.[Abstract][Full Text]

            • 4. Fishbein L, Merrill S, Fraker DL, et al. Inherited mutations in pheochromocytoma and paraganglioma: why all patients should be offered genetic testing. Ann Surg Oncol. 2013 May;20(5):1444-50.[Abstract][Full Text]

            • 5. Liu P, Li M, Guan X, et al. Clinical syndromes and genetic screening strategies of pheochromocytoma and paraganglioma. J Kidney Cancer VHL. 2018 Dec 27;5(4):14-22.[Abstract]

            • 6. Who Classification of Tumours Editorial Board. Endocrine and neuroendocrine tumours: WHO classification of tumours. 5th ed. Geneva: World Health Organization; 2025.​

            • 7. Mete O, Asa SL, Gill AJ, et al. Overview of the 2022 WHO classification of paragangliomas and pheochromocytomas. Endocr Pathol. 2022 Mar;33(1):90-114.[Abstract]

            • 8. Mete O, Juhlin CC. Recent progress in the pathologic classification of pheochromocytomas and paragangliomas. Best Pract Res Clin Endocrinol Metab. 2024 Dec;38(6):101958.[Abstract]

            • 9. Gabi JN, Milhem MM, Tovar YE, et al. Severe Cushing syndrome due to an ACTH-producing pheochromocytoma: a case presentation and review of the literature. J Endocr Soc. 2018 May 24;2(7):621-30.[Abstract][Full Text]

            • 10. Jiang J, Zhang L, Wu Z, et al. A rare case of watery diarrhea, hypokalemia and achlorhydria syndrome caused by pheochromocytoma. BMC Cancer. 2014 Jul 31;14:553.[Abstract][Full Text]

            • 11. Davison AS, Jones DM, Ruthven S, et al. Clinical evaluation and treatment of phaeochromocytoma. Ann Clin Biochem. 2018 Jan;55(1):34-48.[Abstract][Full Text]

            • 12. Ebbehoj A, Stochholm K, Jacobsen SF, et al. Incidence and clinical presentation of pheochromocytoma and sympathetic paraganglioma: a population-based study. J Clin Endocrinol Metab. 2021 Apr 23;106(5):e2251-61.[Abstract][Full Text]

            • 13. Berends AMA, Buitenwerf E, de Krijger RR, et al. Incidence of pheochromocytoma and sympathetic paraganglioma in the Netherlands: a nationwide study and systematic review. Eur J Intern Med. 2018 May;51:68-73.[Abstract][Full Text]

            • 14. Plouin PF, Gimenez-Roqueplo AP. Pheochromocytomas and secreting paragangliomas. Orphanet J Rare Dis. 2006 Dec 8;1:49.[Abstract][Full Text]

            • 15. Leung AA, Pasieka JL, Hyrcza MD, et al. Epidemiology of pheochromocytoma and paraganglioma: population-based cohort study. Eur J Endocrinol. 2021 Jan;184(1):19-28.[Abstract][Full Text]

            • 16. Kim JH, Moon H, Noh J, et al. Epidemiology and prognosis of pheochromocytoma/paraganglioma in Korea: A nationwide study based on the National Health Insurance Service. Endocrinol Metab (Seoul). 2020 Mar;35(1):157-64.[Abstract][Full Text]

            • 17. Chen H, Sippel RS, O'Dorisio MS, et al. The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer. Pancreas. 2010 Aug;39(6):775-83.[Abstract][Full Text]

            • 18. Ebbehoj A, Li D, Kaur RJ, et al. Epidemiology of adrenal tumours in Olmsted County, Minnesota, USA: a population-based cohort study. Lancet Diabetes Endocrinol. 2020 Nov;8(11):894-902.[Abstract][Full Text]

            • 19. Moon JK, Mattei P. Pheochromocytoma and paraganglioma. Semin Pediatr Surg. 2020 Jun;29(3):150926.[Abstract]

            • 20. Jhawar S, Arakawa Y, Kumar S, et al. New insights on the genetics of pheochromocytoma and paraganglioma and its clinical implications. Cancers (Basel). 2022 Jan 25;14(3):594.[Abstract][Full Text]

            • 21. Dariane C, Goncalves J, Timsit MO, et al. An update on adult forms of hereditary pheochromocytomas and paragangliomas. Curr Opin Oncol. 2021 Jan;33(1):23-32.[Abstract]

            • 22. Buffet A, Burnichon N, Favier J, et al. An overview of 20 years of genetic studies in pheochromocytoma and paraganglioma. Best Pract Res Clin Endocrinol Metab. 2020 Mar;34(2):101416.[Abstract]

            • 23. Wachtel H, Fishbein L. Genetics of pheochromocytoma and paraganglioma. Curr Opin Endocrinol Diabetes Obes. 2021 Jun 1;28(3):283-90.[Abstract]

            • 24. Alrezk R, Suarez A, Tena I, et al. Update of pheochromocytoma syndromes: genetics, biochemical evaluation, and imaging. Front Endocrinol (Lausanne). 2018 Nov 27:9:515.[Abstract][Full Text]

            • 25. Patel D, Phay JE, Yen TWF, et al. Update on pheochromocytoma and paraganglioma from the SSO Endocrine/Head and Neck Disease-Site Work Group. Part 1 of 2: Advances in pathogenesis and diagnosis of pheochromocytoma and paraganglioma. Ann Surg Oncol. 2020 May;27(5):1329-37.[Abstract][Full Text]

            • 26. Granberg D, Juhlin CC, Falhammar H. Metastatic pheochromocytomas and abdominal paragangliomas. J Clin Endocrinol Metab. 2021 Apr 23;106(5):e1937-52.[Abstract][Full Text]

            • 27. Fishbein L, Del Rivero J, Else T, et al. The North American Neuroendocrine Tumor Society consensus guidelines for surveillance and management of metastatic and/or unresectable pheochromocytoma and paraganglioma. Pancreas. 2021 Apr 1;50(4):469-93.[Abstract][Full Text]

            • 28. Marini F, Falchetti A, Del Monte F, et al. Multiple endocrine neoplasia type 2. Orphanet J Rare Dis. 2006 Nov 14;1:45.[Abstract][Full Text]

            • 29. Pomares FJ, Canas R, Rodriguez JM, et al. Differences between sporadic and multiple endocrine neoplasia type 2A phaeochromocytoma. Clin Endocrinol (Oxf). 1998 Feb;48(2):195-200.[Abstract]

            • 30. Amodru V, Taieb D, Guerin C, et al. MEN2-related pheochromocytoma: current state of knowledge, specific characteristics in MEN2B, and perspectives. Endocrine. 2020 Sep;69(3):496-503.[Abstract]

            • 31. Maher ER. Von Hippel-Lindau disease. Curr Mol Med. 2004 Dec;4(8):833-42.[Abstract]

            • 32. Castro-Teles J, Sousa-Pinto B, Rebelo S, et al. Pheochromocytomas and paragangliomas in von Hippel-Lindau disease: not a needle in a haystack. Endocr Connect. 2021 Oct 27;10(11):R293-304.[Abstract][Full Text]

            • 33. Louise M Binderup M, Smerdel M, Borgwadt L, et al. von Hippel-Lindau disease: updated guideline for diagnosis and surveillance. Eur J Med Genet. 2022 Aug;65(8):104538.[Abstract][Full Text]

            • 34. Hudler P, Urbancic M. The Role of VHL in the Development of von Hippel-Lindau Disease and Erythrocytosis. Genes (Basel). 2022 Feb 17;13(2):362.[Abstract][Full Text]

            • 35. Amar L, Pacak K, Steichen O, et al. International consensus on initial screening and follow-up of asymptomatic SDHx mutation carriers. Nat Rev Endocrinol. 2021 Jul;17(7):435-44.[Abstract][Full Text]

            • 36. Andrews KA, Ascher DB, Pires DEV, et al. Tumour risks and genotype-phenotype correlations associated with germline variants in succinate dehydrogenase subunit genes SDHB, SDHC and SDHD. J Med Genet. 2018 Jun;55(6):384-94.[Abstract][Full Text]

            • 37. Astuti D, Douglas F, Lennard TW, et al. Germline SDHD mutation in familial phaeochromocytoma. Lancet. 2001 Apr 14;357(9263):1181-2.[Abstract]

            • 38. Sen I, Young WF Jr, Kasperbauer JL, et al. Tumor-specific prognosis of mutation-positive patients with head and neck paragangliomas. J Vasc Surg. 2020 May;71(5):1602-12.e2.[Abstract][Full Text]

            • 39. Walther MM, Herring J, Enquist E, et al. von Recklinghausen's disease and pheochromocytomas. J Urol. 1999 Nov;162(5):1582-6.[Abstract]

            • 40. Zinnamosca L, Petramala L, Cotesta D, et al. Neurofibromatosis type 1 (NF1) and pheochromocytoma: prevalence, clinical and cardiovascular aspects. Arch Dermatol Res. 2011 Jul;303(5):317-25.[Abstract]

            • 41. Gruber LM, Erickson D, Babovic-Vuksanovic D, et al. Pheochromocytoma and paraganglioma in patients with neurofibromatosis type 1. Clin Endocrinol (Oxf). 2017 Jan;86(1):141-9.[Abstract]

            • 42. Shinall MC, Solórzano CC. Pheochromocytoma in neurofibromatosis type 1: when should it be suspected? Endocr Pract. 2014 Aug;20(8):792-6.[Abstract]

            • 43. Rogowski-Lehmann N, Geroula A, Prejbisz A, et al. Missed clinical clues in patients with pheochromocytoma/paraganglioma discovered by imaging. Endocr Connect. 2018 Sep 1;7(11):1168-77.[Abstract][Full Text]

            • 44. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016 Aug;175(2):G1-G34.[Abstract][Full Text]

            • 45. Zeiger MA, Thompson GB, Duh QY, et al. American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas: executive summary of recommendations. Endocr Pract. 2009 Jul-Aug;15(5):450-3.[Abstract]

            • 46. Zuber SM, Kantorovich V, Pacak K. Hypertension in pheochromocytoma: characteristics and treatment. Endocrinol Metab Clin North Am. 2011 Jun;40(2):295-311.[Abstract]

            • 47. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors [internet publication].[Full Text]

            • 48. Kunz PL, Reidy-Lagunes D, Anthony LB, et al; North American Neuroendocrine Tumor Society. Consensus guidelines for the management and treatment of neuroendocrine tumors. Pancreas. 2013 May;42(4):557-77.[Abstract][Full Text]

            • 49. American Society for Clinical Pathology. Choosing Wisely, an initiative of the ABIM Foundation. Thirty five things physicians and patients should question. Sep 2020 [internet publication].[Full Text]

            • 50. Nölting S, Bechmann N, Taieb D, et al. Personalized management of pheochromocytoma and paraganglioma. Endocr Rev. 2022 Mar 9;43(2):199-239.[Abstract][Full Text]

            • 51. Remde H, Pamporaki C, Quinkler M, et al. Improved diagnostic accuracy of clonidine suppression testing using an age-related cutoff for plasma normetanephrine. Hypertension. 2022 Jun;79(6):1257-64.[Abstract][Full Text]

            • 52. Algeciras-Schimnich A, Preissner CM, Young WF Jr, et al. Plasma chromogranin A or urine fractionated metanephrines follow-up testing improves the diagnostic accuracy of plasma fractionated metanephrines for pheochromocytoma. J Clin Endocrinol Metab. 2008 Jan;93(1):91-5.[Abstract][Full Text]

            • 53. Timmers HJLM, Taïeb D, Pacak K, et al. Imaging of pheochromocytomas and paragangliomas. Endocr Rev. 2024 May 7;45(3):414-34.[Abstract][Full Text]

            • 54. American College of Radiology. ACR appropriateness criteria: adrenal mass evaluation. 2021 [internet publication].​[Full Text]

            • 55. Janssen I, Blanchet EM, Adams K, et al. Superiority of [68Ga]-DOTATATE PET/CT to other functional imaging modalities in the localization of SDHB-associated metastatic pheochromocytoma and paraganglioma. Clin Cancer Res. 2015 Sep 1;21(17):3888-95.[Abstract][Full Text]

            • 56. Plouin PF, Amar L, Dekkers OM, et al; Guideline Working Group. European Society of Endocrinology clinical practice guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma. Eur J Endocrinol. 2016 May;174(5):G1-10.[Abstract][Full Text]

            • 57. Manger WM, Gifford RW. Pheochromocytoma. J Clin Hypertens (Greenwich). 2002 Jan-Feb;4(1):62-72.[Abstract]

            • 58. Komada H, Hirota Y, So A, et al. Insulin secretion and insulin sensitivity before and after surgical treatment of pheochromocytoma or paraganglioma. J Clin Endocrinol Metab. 2017 Sep 1;102(9):3400-5.[Abstract][Full Text]

            • 59. Lopez C, Bima C, Bollati M, et al. Pathophysiology and management of glycemic alterations before and after surgery for pheochromocytoma and paraganglioma. Int J Mol Sci. 2023 Mar 8;24(6):5153[Abstract][Full Text]

            • 60. Drenou B, Le Tulzo Y, Caulet-Maugendre S, et al. Pheochromocytoma and secondary erythrocytosis: role of tumor erythropoietin secretion. Nouv Rev Fr Hematol. 1995;37(3):197-9.[Abstract]

            • 61. Grossrubatscher E, Dalino P, Vignati F, et al. The role of chromogranin A in the management of patients with pheochromocytoma. Clin Endocrinol. 2006 Sep;65(3):287-93.[Abstract]

            • 62. Sjoberg RJ, Simcic KJ, Kidd GS. The clonidine suppression test for pheochromocytoma: a review of its utility and pitfalls. Arch Intern Med. 1992 Jun;152(6):1193-7.[Abstract]

            • 63. Fagundes GFC, Almeida MQ. Pitfalls in the diagnostic evaluation of pheochromocytomas. J Endocr Soc. 2024 Apr 6;8(6):bvae078.[Abstract][Full Text]

            • 64. Sinnott B, Hatipoglu B. Adrenal incidentaloma in pregnancy. Endocrinologist. 2005 Jul/Aug;15(4):205-8.

            • 65. Sarathi VL, Lila AR, Bandgar TR, et al. Pheochromocytoma and pregnancy: a rare but dangerous combination. Endocr Pract. 2010 Mar-Apr;16(2):300-9.[Abstract]

            • 66. Nazari MA, Hasan R, Haigney M, et al. Catecholamine-induced hypertensive crises: current insights and management. Lancet Diabetes Endocrinol. 2023 Dec;11(12):942-54.[Abstract]

            • 67. Nicholson JP Jr, Vaughn ED Jr, Pickering TG, et al. Pheochromocytoma and prazosin. Ann Int Med. 1983 Oct;99(4):477-9.[Abstract]

            • 68. National Center for Biotechnology Information. PubChem: metyrosine. Apr 2025 [internet publication].[Full Text]

            • 69. Tada K, Okuda T, Yamashita K. Three cases of malignant pheochromocytoma treated with cyclophosphamide, vincristine and dacarbazine combination chemotherapy and alpha-methyl-p-tyrosine to control hypercatecholaminemia. Horm Res. 1998;49(6):295-7.[Abstract]

            • 70. Patel D, Phay JE, Yen TWF, et al. Update on pheochromocytoma and paraganglioma from the SSO Endocrine and Head and Neck Disease Site Working Group, part 2 of 2: perioperative management and outcomes of pheochromocytoma and paraganglioma. Ann Surg Oncol. 2020 May;27(5):1338-47.[Abstract][Full Text]

            • 71. Yip L, Duh QY, Wachtel H, et al. American Association of Endocrine Surgeons guidelines for adrenalectomy: executive summary. JAMA Surg. 2022 Oct 1;157(10):870-7.[Abstract][Full Text]

            • 72. Hue JJ, Alvarado C, Bachman K, et al. Outcomes of malignant pheochromocytoma based on operative approach: a National Cancer Database analysis. Surgery. 2021 Oct;170(4):1093-8.[Abstract]

            • 73. Petri BJ, van Eijck CH, de Herder WW, et al. Phaeochromocytomas and sympathetic paragangliomas. Br J Surg. 2009 Dec;96(12):1381-92.[Abstract][Full Text]

            • 74. Jimenez C, Xu G, Varghese J, et al. New directions in treatment of metastatic or advanced pheochromocytomas and sympathetic paragangliomas: an American, contemporary, pragmatic approach. Curr Oncol Rep. 2022 Jan;24(1):89-98.[Abstract]

            • 75. Tena I, Gupta G, Tajahuerce M, et al. Successful second-line metronomic temozolomide in metastatic paraganglioma: case reports and review of the literature. Clin Med Insights Oncol. 2018 Apr 9:12:1179554918763367.[Abstract][Full Text]

            • 76. Tong A, Li M, Cui Y, et al. Temozolomide is a potential therapeutic tool for patients with metastatic pheochromocytoma/paraganglioma-case report and review of the literature. Front Endocrinol (Lausanne). 2020 Feb 18:11:61.[Abstract][Full Text]

            • 77. Breen W, Bancos I, Young WF Jr, et al. External beam radiation therapy for advanced/unresectable malignant paraganglioma and pheochromocytoma. Adv Radiat Oncol. 2017 Nov 22;3(1):25-9.[Abstract][Full Text]

            • 78. Fishbein L, Bonner L, Torigian DA, et al. External beam radiation therapy (EBRT) for patients with malignant pheochromocytoma and non-head and -neck paraganglioma: combination with 131I-MIBG. Horm Metab Res. 2012 May;44(5):405-10.[Abstract]

            • 79. Baudin E, Goichot B, Berruti A, et al. Sunitinib for metastatic progressive phaeochromocytomas and paragangliomas: results from FIRSTMAPPP, an academic, multicentre, international, randomised, placebo-controlled, double-blind, phase 2 trial. Lancet. 2024 Mar 16;403(10431):1061-70.[Abstract]

            • 80. Pacak K, Fojo T, Goldstein DS, et al. Radiofrequency ablation: a novel approach for treatment of metastatic pheochromocytoma. J Natl Cancer Inst. 2001 Apr 18;93(8):648-9.[Abstract][Full Text]

            • 81. Yip L, Lee JE, Shapiro SE. Surgical management of hereditary pheochromocytoma. J Am Coll Surg. 2004 Apr;198(4):525-34.[Abstract]

            • 82. Plouin PF, Duclos JM, Soppelsa F, et al. Factors associated with perioperative morbidity and mortality in patients with pheochromocytoma: analysis of 165 operations at a single center. J Clin Endocrinol Metab. 2001 Apr;86(4):1480-6.[Abstract][Full Text]

            • 83. Kinney MA, Narr BJ, Warner MA. Perioperative management of pheochromocytoma. J Cardiothorac Vasc Anesth. 2002 Jun;16(3):359-69.[Abstract]

            • 84. Akiba M, Kodama T, Ito Y, et al. Hypoglycemia induced by excessive rebound secretion of insulin after removal of pheochromocytoma. World J Surg. 1990 May-Jun;14(3):317-24.[Abstract]

            • 85. Radtke WE, Kazmier FJ, Rutherford BD, et al. Cardiovascular complications of pheochromocytoma crisis. Am J Cardiol. 1975 May;35(5):701-5.[Abstract]

            • 86. Steinsapir J, Carr AA, Prisant LM, et al. Metyrosine and pheochromocytoma. Arch Intern Med. 1997 Apr 28;157(8):901-6.[Abstract]

            • 87. Pang Y, Liu Y, Pacak K, et al. Pheochromocytomas and paragangliomas: from genetic diversity to targeted therapies. Cancers (Basel). 2019 Mar 28;11(4):436.[Abstract][Full Text]

            • 88. Winzeler B, Challis BG, Casey RT. Precision medicine in phaeochromocytoma and paraganglioma. J Pers Med. 2021 Nov 22;11(11):1239.[Abstract][Full Text]

            • 89. Giubellino A, Sourbier C, Lee MJ, et al. Targeting heat shock protein 90 for the treatment of malignant pheochromocytoma. PLoS One. 2013;8(2):e56083.[Abstract][Full Text]

            • 90. Amar L, Lussey-Lepoutre C, Lenders JW, et al. Management of endocrine disease: recurrence or new tumors after complete resection of pheochromocytomas and paragangliomas: a systematic review and meta-analysis. Eur J Endocrinol. 2016 Oct;175(4):R135-45.[Abstract]

            • 91. Fung MM, Viveros OH, O'Connor DT. Diseases of the adrenal medulla. Acta Physiol (Oxf). 2008 Feb;192(2):325-35.[Abstract]

            • 92. Hamidi O, Young WF Jr, Gruber L, et al. Outcomes of patients with metastatic phaeochromocytoma and paraganglioma: a systematic review and meta-analysis. Clin Endocrinol (Oxf). 2017 Nov;87(5):440-50.[Abstract]

            • 93. Yoshida S, Hatori M, Noshiro T, et al. Twenty-six-years' survival with multiple bone metastasis of malignant pheochromocytoma. Arch Orthop Trauma Surg. 2001 Nov;121(10):598-600.[Abstract]

            • 94. Mei L, Khurana A, Al-Juhaishi T, et al. Prognostic factors of malignant pheochromocytoma and paraganglioma: a combined SEER and TCGA databases review. Horm Metab Res. 2019 Jul;51(7):451-7.[Abstract]

            • 95. Nölting S, Ullrich M, Pietzsch J, et al. Current management of pheochromocytoma/paraganglioma: a guide for the practicing clinician in the era of precision medicine. Cancers (Basel). 2019 Oct 8;11(10):1505.[Abstract][Full Text]

            • 96. Tan SG, Koay CK, Chan ST. The use of vasopressin to treat catecholamine-resistant hypotension after pheochromocyoma removal. Anaesth Intensive Care. 2002 Aug;30(4):477-80.[Abstract]

            • 97. Rana HQ, Rainville IR, Vaidya A. Genetic testing in the clinical care of patients with pheochromocytoma and paraganglioma. Curr Opin Endocrinol Diabetes Obes. 2014 Jun;21(3):166-76.[Abstract]

            • 98. Hampel H, Bennett RL, Buchanan A, et al. A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment. Genet Med. 2015 Jan;17(1):70-87.[Abstract][Full Text]

            • 99. Lenders JW, Pacak K, Walther MM, et al. Biochemical diagnosis of pheochromocytoma: which test is best? JAMA. 2002 Mar 20;287(11):1427-34.[Abstract][Full Text]

            • 100. Huang KH, Chung SD, Chen SC, et al. Clinical and pathological data of 10 malignant pheochromocytomas: long-term follow up in a single institution. Int J Urol. 2007 Mar;14(3):181-5.[Abstract]

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