Presenting Symptoms, Vitals, and First Workup Steps

Join the Behind the Knife Surgical Oncology Team as we discuss the nuances in the work up and management of patients with pheochromocytomas.

Hosts:
Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center.

Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles.

Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 2ndYear Surgical Oncology fellow at MD Anderson.

Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a General Surgery physician in the United States Air Force station at RAF Lakenheath.

Joe (Joseph) Broderick, MD, MA (@joebrod5) is a General Surgery research resident between his second and third year at Brooke Army Medical Center.

Galen Gist, MD (@gistgalen) is a General Surgery research resident between his second and third year at Brooke Army Medical Center.

Learning Objectives:
1)    Review the presentation of patients with pheochromocytomas. 

2)    Review the work up of patients with pheochromocytomas. 

3)    Review the treatment of patients with pheochromocytomas. 

4)    Review the surveillance of patients with pheochromocytomas. 

References used in the making of this episode:
Patel D. Surgical approach to patients with pheochromocytoma. Gland Surg. 2020;9(1):32-42. doi:10.21037/gs.2019.10.20. PMID: 32206597; PMCID:PMC7082266.
 
Eisenhofer G, Lenders JW, Siegert G, et al. Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status. Eur J Cancer. 2012;48(11):1739-1749. doi:10.1016/j.ejca.2011.07.016. PMID:22036874; PMCID: PMC3372624.
 
Lenders JWM, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma. Lancet. 2005;366(9486):665-675. doi:10.1016/S0140-6736(05)67139-5.
 
Vicha A, Musil Z, Pacak K. Genetics of pheochromocytoma and paraganglioma syndromes: new advances and future treatment options. Curr Opin Endocrinol Diabetes Obes. 2013;20(3):186-191. doi:10.1097/MED.0b013e32835fcc45. PMID: 23481210; PMCID: PMC4711348. https://pubmed.ncbi.nlm.nih.gov/23481210/

Dickson PV, Alex GC, Grubbs EG, et al. Posterior retroperitoneoscopic adrenalectomy is a safe and effective alternative to transabdominal laparoscopic adrenalectomy for pheochromocytoma. Surgery. 2011;150(3):452-458. doi:10.1016/j.surg.2011.07.004. https://pubmed.ncbi.nlm.nih.gov/21878230/

Lei K, Wang X, Yang Z, et al. Comparison of the retroperitoneal laparoscopic adrenalectomy versus transperitoneal laparoscopic adrenalectomy for large (≥6 cm) pheochromocytomas: a single-centre retrospective study. Front Oncol. 2023;13:1043753. doi:10.3389/fonc.2023.1043753. PMID: 36910608; PMCID: PMC9992891. https://pubmed.ncbi.nlm.nih.gov/36910608/

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