The Endocrine Society has released clinical practice guidelines for the management of pheochromocytomas and paragangliomas…
Surgical resection of a tumor is the treatment of choice and usually results in a cure of the hypertension. Careful preoperative management is required to control blood pressure, heart rate, fluid volume, and to prevent intraoperative hypertensive crises. Blood pressure, heart rate, and glucose levels should be monitored immediately after surgery.
Preoperative blockade of hormonally functional PPGL to prevent cardiovascular complications is recommended, along with preoperative medical treatment to normalize blood pressure and heart rate combined with a high-sodium diet with fluid intake to prevent severe hypotension after removal of the tumor.
Minimally invasive (eg, laparoscopic) adrenalectomy should be performed for most adrenal pheochromocytomas, with open resection reserved for large or invasive pheochromocytomas; open resection is suggested for paragangliomas, but laparoscopic resection is an option for smaller tumors; partial adrenalectomy is also an option for certain patients.