What are the TES/AACC/ESE recommendations for preoperative management of pheochromocytoma and paraganglioma?

Updated: Feb 12, 2019
  • Author: Cameron K Tebbi, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

For preoperative management, TES/AACC/ESE recommendations include the following:

  • Blockade of hormonally functional PPGL to prevent cardiovascular complications

  • Medical treatment to normalize blood pressure and heart rate

  • A high-sodium diet with supplemental fluid intake to prevent severe hypotension after removal of the tumor

The TES/AACC/ESE guidelines recommend minimally invasive (eg, laparoscopic) adrenalectomy for most adrenal pheochromocytomas, with open resection reserved for very large or invasive pheochromocytomas. Open resection is suggested for paragangliomas, although laparoscopic resection is an option for smaller tumors. Partial adrenalectomy is also a possibility for certain types of patients.


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