Postoperative management in patients with Pheochromocytoma and Paraganglioma

Divya Mamilla, Katherine Araque, Alessandra Brofferio, Melissa K. Gonzales, James N. Sullivan, Naris Nilubol, Karel Pacak

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Pheochromocytomas and paragangliomas (PPGLs) are rare catecholamine-secreting neuroendocrine tumors of the adrenal medulla and sympathetic/parasympathetic ganglion cells, respectively. Excessive release of catecholamines leads to episodic symptoms and signs of PPGL, which include hypertension, headache, palpitations, and diaphoresis. Intraoperatively, large amounts of catecholamines are released into the bloodstream through handling and manipulation of the tumor(s). In contrast, there could also be an abrupt decline in catecholamine levels after tumor resection. Because of such binary manifestations of PPGL, patients may develop perplexing and substantially devastating cardiovascular complications during the perioperative period. These complications include hypertension, hypotension, arrhythmias, myocardial infarction, heart failure, and cerebrovascular accident. Other complications seen in the postoperative period include fever, hypoglycemia, cortisol deficiency, urinary retention, etc. In the interest of safe patient care, such emergencies require precise diagnosis and treatment. Surgeons, anesthesiologists, and intensivists must be aware of the clinical manifestations and complications associated with a sudden increase or decrease in catecholamine levels and should work closely together to be able to provide appropriate management to minimize morbidity and mortality associated with PPGLs.

Original languageEnglish (US)
Article number936
JournalCancers
Volume11
Issue number7
DOIs
StatePublished - Jul 2019

Fingerprint

Paraganglioma
Pheochromocytoma
Catecholamines
Parasympathetic Ganglia
Hypertension
Sympathetic Ganglia
Perioperative Period
Adrenal Medulla
Urinary Retention
Neuroendocrine Tumors
Hypoglycemia
Postoperative Period
Hypotension
Signs and Symptoms
Headache
Hydrocortisone
Cardiac Arrhythmias
Neoplasms
Patient Care
Emergencies

Keywords

  • Arrhythmia
  • Hypertension
  • Hypotension
  • Pheochromocytoma
  • Postoperative

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Mamilla, D., Araque, K., Brofferio, A., Gonzales, M. K., Sullivan, J. N., Nilubol, N., & Pacak, K. (2019). Postoperative management in patients with Pheochromocytoma and Paraganglioma. Cancers, 11(7), [936]. https://doi.org/10.3390/cancers11070936

Postoperative management in patients with Pheochromocytoma and Paraganglioma. / Mamilla, Divya; Araque, Katherine; Brofferio, Alessandra; Gonzales, Melissa K.; Sullivan, James N.; Nilubol, Naris; Pacak, Karel.

In: Cancers, Vol. 11, No. 7, 936, 07.2019.

Research output: Contribution to journalReview article

Mamilla, D, Araque, K, Brofferio, A, Gonzales, MK, Sullivan, JN, Nilubol, N & Pacak, K 2019, 'Postoperative management in patients with Pheochromocytoma and Paraganglioma', Cancers, vol. 11, no. 7, 936. https://doi.org/10.3390/cancers11070936
Mamilla, Divya ; Araque, Katherine ; Brofferio, Alessandra ; Gonzales, Melissa K. ; Sullivan, James N. ; Nilubol, Naris ; Pacak, Karel. / Postoperative management in patients with Pheochromocytoma and Paraganglioma. In: Cancers. 2019 ; Vol. 11, No. 7.
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