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Differences in Clinical Presentation Between Pheochromocytomas and Paragangliomas.

Vincent E D Pihlblad1, Jan Calissendorff1,2, Henrik Falhammar1,2

  • 1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Clinical Endocrinology
|July 11, 2025
PubMed
Summary

Pheochromocytomas (PCCs) and paragangliomas (PGLs) share many clinical features. However, PCCs are more often associated with palpitations, anxiety, and diabetes, though these differences aren't enough to distinguish them clinically.

Keywords:
adrenal incidentalomaadrenal medullary tumourdiagnosisparagangliomapheochromocytomasignssymptoms

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Area of Science:

  • Endocrinology
  • Oncology
  • Genetics

Background:

  • Pheochromocytomas (PCCs) and sympathetic paragangliomas (PGLs) are neuroendocrine tumors arising from chromaffin cells.
  • While genetically distinct, their clinical presentations often overlap, posing diagnostic challenges.

Purpose of the Study:

  • To investigate and compare the clinical presentation, biochemical profiles, and comorbidities between PCCs and PGLs.
  • To identify potential differentiating factors between these two tumor types.

Main Methods:

  • Retrospective cohort study of 201 patients with PPGLs.
  • Data collected included demographics, tumor characteristics, genetic profiles, symptoms, comorbidities, and biochemical data.
  • Comparison of clinical and biochemical parameters between pheochromocytoma and paraganglioma groups.

Main Results:

  • Women were less prevalent in the pheochromocytoma group (51.5% vs. 71.1%).
  • Pheochromocytomas produced more epinephrine and were associated with higher rates of palpitations, anxiety, and pre-diabetes/diabetes.
  • Despite differences, the classic triad and hypertension prevalence were similar between groups.

Conclusions:

  • Pheochromocytomas and paragangliomas exhibit distinct clinical and biochemical features, including symptom profiles and hormone production.
  • These differences are subtle and insufficient for definitive clinical differentiation between PCCs and PGLs based solely on presentation.