Feocromocitomas e Paragangliomas: Revisão Atualizada sobre o Diagnóstico e Manejo Terapêutico

Abstract

Pheochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumors originating from chromaffin cells, with malignant potential and a high risk of cardiovascular complications. Over the past decades, the understanding of these neoplasms has advanced substantially, driven by progress in genetic and imaging techniques. This study aims to review and critically analyze recent updates in the diagnosis and treatment of PPGL, emphasizing genetic, biochemical, and therapeutic innovations that have transformed current clinical practice. It is a narrative literature review based on publications indexed in PubMed, Scielo, and ScienceDirect databases, covering the last five years. Original articles, systematic reviews, and guidelines from international medical societies were prioritized. A significant change in PPGL management was observed, with the incorporation of genetic sequencing and functional imaging methods such as gallium-68 PET/CT, which improved diagnostic accuracy and allowed for more individualized approaches. In the therapeutic field, the integration of multimodal strategies combining surgery, preoperative preparation, and radionuclide or targeted therapies has been highlighted. Despite these advances, challenges remain regarding protocol standardization, unequal access to advanced technologies, and the lack of multicenter studies in middle-income countries. It is concluded that the management of PPGL requires a multidisciplinary approach and public health policies that ensure equitable access to diagnostic and therapeutic resources.