# Preoperative Management of Pheochromocytoma and Paraganglioma

## TL;DR

This paper reviews the preoperative management of pheochromocytoma and paraganglioma, focusing on preventing dangerous cardiovascular complications during surgery.

## Contribution

The paper summarizes recent studies comparing preoperative management with or without alpha-adrenergic-receptor antagonists.

## Key findings

- Proper preoperative management is crucial to prevent lethal cardiovascular complications during surgery.
- Use of alpha-adrenergic-receptor antagonists is a key part of preoperative preparation.
- Recent studies help clarify the effectiveness of various preoperative management strategies.

## Abstract

Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumors, characterized by excessive release of catecholamines (CAs), and manifested as the classic triad of headaches, palpitations, profuse sweating, and a variety of other signs and symptoms. The diagnosis of PPGL requires both evidence of excessive release of CAs and anatomical localization of CA-secreting tumor. Surgery is the mainstay of treatment for all patients with PPGL unless contraindicated. However, without proper preparation, the release of excessive CAs, especially during surgery, can result in lethal cardiovascular complications. Herein, we briefly reviewed the pathogenesis of this disease, discussed the current approaches and evidence available for preoperative management, summarizing the results of the latest studies which compared the efficacies of preoperative management with or without α adrenergic-receptor antagonists, aiming to facilitate better understanding of the preoperative management of PPGL for the physicians.