Pheochromocytoma and paraganglioma (PPGL)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DIS-PHEOCHROMOCYTOMA |
|---|---|
| Type | Disease |
| Aliases | Adrenal medullary tumorCatecholamine-secreting tumorPPGLParagangliomaPheochromocytomaФеохромоцитома та парагангліома (PPGL) |
| Status | reviewed 2026-05-19 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-GENETIC-FAMILIAL-BREAST-OVARIAN-2025 SRC-NCCN-NET-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 8700/0 |
|---|---|
| icd_o_3_topography | ["C74.1"] |
| icd_10 | D35.0 |
| who_classification | WHO Endocrine and Neuroendocrine Tumours 5th ed (2022): Pheochromocytoma and extra-adrenal paragangliomas |
Notes
Pheochromocytoma is a catecholamine-secreting neuroendocrine tumor of adrenal medullary origin; extra-adrenal counterparts (paragangliomas) arise from sympathetic / parasympathetic ganglia (head/neck, thoracic, abdominal). They are biologically and clinically a single spectrum (PPGL); this entity is anchored to the adrenal subset for ICD-10 cleanliness but cross-references SDHx-driven extra-adrenal paragangliomas in prevention workstream notes. Hereditary fraction is the highest known among adult cancers (~30–40%). NCCN and Endocrine Society recommend germline panel testing (RET, VHL, SDHB/C/D/AF2, NF1, TMEM127, MAX, FH) for ALL patients with PPGL — not restricted by family history. This makes PPGL a sentinel disease for hereditary cancer surveillance pathways (RET → MEN2 prophylactic thyroidectomy; VHL → multi-organ surveillance; SDHB → lifetime PPGL + RCC surveillance). Classical clinical triad: headache + palpitations + sweating; many patients present with paroxysmal or sustained hypertension. Biochemical diagnosis: plasma free metanephrines or 24-h urinary fractionated metanephrines (preferred over catecholamines). Functional imaging (MIBG, Ga-68 DOTATATE PET) for staging and...
Used By
Actionability
BMA-METANEPHRINES-PHEO-VHL-MEN2-SURVEILLANCE- Plasma free metanephrines are the gold-standard biochemical test for pheochromocytoma and...
Algorithms
ALGO-MEN2-CARRIER-PROPHYLACTIC-THYROIDECTOMY-TIMING- ALGO-MEN2-CARRIER-PROPHYLACTIC-THYROIDECTOMY-TIMINGALGO-PHEO-1L- ALGO-PHEO-1LALGO-VHL-CARRIER-SURVEILLANCE-VHL-ALLIANCE- ALGO-VHL-CARRIER-SURVEILLANCE-VHL-ALLIANCE
Disease
DIS-ADRENOCORTICAL-CARCINOMA- Adrenocortical carcinoma (ACC)DIS-PARAGANGLIOMA- Paraganglioma (PGL)
Indication
IND-PHEO-LOCALIZED-1L-ALPHA-BLOCKADE-ADRENALECTOMY- IND-PHEO-LOCALIZED-1L-ALPHA-BLOCKADE-ADRENALECTOMYIND-PHEO-METASTATIC-1L-CABOZANTINIB- IND-PHEO-METASTATIC-1L-CABOZANTINIBIND-PHEO-METASTATIC-1L-MIBG- IND-PHEO-METASTATIC-1L-MIBGIND-PHEO-METASTATIC-1L-SUNITINIB- IND-PHEO-METASTATIC-1L-SUNITINIBIND-SDH-CARRIER-INTENSIFIED- IND-SDH-CARRIER-INTENSIFIEDIND-SDH-CARRIER-SURVEILLANCE- IND-SDH-CARRIER-SURVEILLANCEIND-SDH-SUSPICION-PREVENTION-ENHANCED-SURVEILLANCE- IND-SDH-SUSPICION-PREVENTION-ENHANCED-SURVEILLANCEIND-SDH-SUSPICION-PREVENTION-GENETIC-COUNSELING- IND-SDH-SUSPICION-PREVENTION-GENETIC-COUNSELINGIND-SDHA-CARRIER-SURVEILLANCE- IND-SDHA-CARRIER-SURVEILLANCEIND-SDHA-CARRIER-SYMPTOM-DRIVEN- IND-SDHA-CARRIER-SYMPTOM-DRIVENIND-SDHB-CARRIER-INTENSIFIED- IND-SDHB-CARRIER-INTENSIFIEDIND-SDHB-CARRIER-SURVEILLANCE- IND-SDHB-CARRIER-SURVEILLANCEIND-SDHC-CARRIER-SURVEILLANCE- IND-SDHC-CARRIER-SURVEILLANCEIND-SDHC-CARRIER-SYMPTOM-DRIVEN- IND-SDHC-CARRIER-SYMPTOM-DRIVEN
Procedures
PROC-NEPHRON-SPARING-PARTIAL-NEPHRECTOMY-VHL- Nephron-sparing partial nephrectomy for VHL renal lesion (≥3 cm threshold)PROC-PROPHYLACTIC-THYROIDECTOMY-MEN2- Prophylactic total thyroidectomy in MEN2 / RET-mutation carriers
Red flag
RF-CASCADE-VHL-FDR-POSITIVE- A first-degree relative of the patient (parent, sibling, or child) has a documented posit...RF-MEN2-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in the RET proto-oncogene — MEN...RF-PHEO-INADEQUATE-ALPHA-BLOCKADE- Pheochromocytoma / paraganglioma surgery (adrenalectomy) is planned or imminent WITHOUT d...RF-SDH-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in one of the SDHx genes — SDHB...RF-SDH-FAMILY-HISTORY-SUSPICION- Family pedigree suggestive of SDH (succinate dehydrogenase) deficiency syndrome — confirm...RF-SDHA-SPECIFIC-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in SDHA (succinate dehydrogenas...RF-SDHB-SPECIFIC-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in SDHB (succinate dehydrogenas...RF-SDHC-SPECIFIC-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in SDHC (succinate dehydrogenas...RF-VHL-CONFIRMED-CARRIER- Patient has a confirmed germline VHL pathogenic variant (positive germline test result, d...
Sources
SRC-ENDOCRINE-SOCIETY-PPGL-2014- Pheochromocytoma and Paraganglioma: An Endocrine Society Clinical Practice GuidelineSRC-FIRSTMAPPP-BAUDIN-2024- Sunitinib for metastatic progressive phaeochromocytomas and paragangliomas: results from...