Diagnostic and Management Challenges in Pheochromocytoma and Paraganglioma: A Clinical Review

Pheochromocytoma and paraganglioma are rare neuroendocrine tumors with a prevalence of less than 0.05%. Being rather uncommon, they pose significant diagnostic challenges as the symptom complex is nonspecific. We present a clinical review based on the published literature and our center's experience in managing pheochromocytoma and paragangliomas over the past two decades. At the onset, summaries of three representative pheochromocytoma and paraganglioma cases are provided to highlight common diagnostic challenges. A holistic approach, combining biochemical evaluation with particular attention to pretest probability, accurate interpretation of imaging data, and differentiation from other adrenal masses, can aid in establishing the diagnosis and guiding appropriate management. Thus, the careful selection and interpretation of clinical, biochemical and imaging parameters are essential to improve diagnostic accuracy and optimize patient management.