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Malignant pheochromocytomas and paragangliomas: a diagnostic challenge

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Abstract

Introduction

Malignant pheochromocytomas (PCCs) and paragangliomas (PGLs) are rare disorders arising from the adrenal gland, from the glomera along parasympathetic nerves or from paraganglia along the sympathetic trunk. According to the WHO classification, malignancy of PCCs and PGLs is defined by the presence of metastases at non-chromaffin sites distant from that of the primary tumor and not by local invasion. The overall prognosis of metastasized PCCs/PGLs is poor. Surgery offers currently the only change of cure. Preferably, the discrimination between malignant and benign PCCs/PGLs should be made preoperatively.

Methods

This review summarizes our current knowledge on how benign and malignant tumors can be distinguished.

Conclusion

Due to the rarity of malignant PCCs/PGLs and the obvious difficulties in distinguishing benign and malignant PCCs/PGLs, any patient with a PCC/PGL should be treated in a specialized center where a multidisciplinary setting with specialized teams consisting of radiologists, endocrinologist, oncologists, pathologists and surgeons is available. This would also facilitate future studies to address the existing diagnostic and/or therapeutic obstacles.

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Authors and Affiliations

  1. Department of Surgery, County Council of Östergötland, Linköping, Sweden

    Oliver Gimm

  2. Divison of Surgery, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden

    Oliver Gimm

  3. Laboratoire d’Anatomie et de Cytologie Pathologique, Faculté de Médecine, Marseille, France

    Catherine DeMicco

  4. Institute of Pathology, University of Bern, Bern, Switzerland

    Aurel Perren

  5. Médecine Nucléaire—Centre Hospitalier Lyon Sud (Hospices Civils de Lyon), Université Claude Bernard Lyon 1—EMR 3738 (Faculté Charles Mérieux Lyon Sud), Lyon, France

    Francesco Giammarile

  6. Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Essen, Germany

    Martin K. Walz

  7. Department of Digestive, Hepatobiliary and Endocrine Surgery CHU Nancy-Brabois (hopital adultes), University of Nancy, Nancy, France

    Laurent Brunaud

  8. Department of Surgery, Division of Endocrine Surgery, Linköping University, 58185, Linköping, Sweden

    Oliver Gimm

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Gimm, O., DeMicco, C., Perren, A. et al. Malignant pheochromocytomas and paragangliomas: a diagnostic challenge. Langenbecks Arch Surg 397, 155–177 (2012). https://doi.org/10.1007/s00423-011-0880-x

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