Clinical Challenges in Surgical Oncology: Pheochromocytomas

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 2 October 2025

⏱️ 29 minutes

🔗️ Recording | iTunes | RSS

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Summary

Join the Behind the Knife Surgical Oncology Team as we discuss the nuances in the work up and management of patients with pheochromocytomas.

Hosts:
Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center.

Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles.

Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 2ndYear Surgical Oncology fellow at MD Anderson.

Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a General Surgery physician in the United States Air Force station at RAF Lakenheath.

Joe (Joseph) Broderick, MD, MA (@joebrod5) is a General Surgery research resident between his second and third year at Brooke Army Medical Center.

Galen Gist, MD (@gistgalen) is a General Surgery research resident between his second and third year at Brooke Army Medical Center.

Learning Objectives:
1) Review the presentation of patients with pheochromocytomas.

2) Review the work up of patients with pheochromocytomas.

3) Review the treatment of patients with pheochromocytomas.

4) Review the surveillance of patients with pheochromocytomas.

References used in the making of this episode:
Patel D. Surgical approach to patients with pheochromocytoma. Gland Surg. 2020;9(1):32-42. doi:10.21037/gs.2019.10.20. PMID: 32206597; PMCID:PMC7082266.

Eisenhofer G, Lenders JW, Siegert G, et al. Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status. Eur J Cancer. 2012;48(11):1739-1749. doi:10.1016/j.ejca.2011.07.016. PMID:22036874; PMCID: PMC3372624.

Lenders JWM, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma. Lancet. 2005;366(9486):665-675. doi:10.1016/S0140-6736(05)67139-5.

Vicha A, Musil Z, Pacak K. Genetics of pheochromocytoma and paraganglioma syndromes: new advances and future treatment options. Curr Opin Endocrinol Diabetes Obes. 2013;20(3):186-191. doi:10.1097/MED.0b013e32835fcc45. PMID: 23481210; PMCID: PMC4711348. https://pubmed.ncbi.nlm.nih.gov/23481210/

Dickson PV, Alex GC, Grubbs EG, et al. Posterior retroperitoneoscopic adrenalectomy is a safe and effective alternative to transabdominal laparoscopic adrenalectomy for pheochromocytoma. Surgery. 2011;150(3):452-458. doi:10.1016/j.surg.2011.07.004. https://pubmed.ncbi.nlm.nih.gov/21878230/

Lei K, Wang X, Yang Z, et al. Comparison of the retroperitoneal laparoscopic adrenalectomy versus transperitoneal laparoscopic adrenalectomy for large (≥6 cm) pheochromocytomas: a single-centre retrospective study. Front Oncol. 2023;13:1043753. doi:10.3389/fonc.2023.1043753. PMID: 36910608; PMCID: PMC9992891. https://pubmed.ncbi.nlm.nih.gov/36910608/

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Transcript

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0:00.0	Behind the Night, The Surgery Podcast, relevant and engaging content designed to help you Behind the Night.
0:24.0	This is Jason here.
0:25.1	If you're prepping for the complex general surgical oncology boards or just looking to level up your surge oncology game, you need to check out our surgical oncology board review.
0:33.2	This isn't some lame review with just flashcards and outlines.
0:36.8	We've created comprehensive high-yield scenarios covering the most tested diseases,
0:41.3	plus expert commentary, and updated guidelines that actually stick and are proven to help you pass the boards.
0:47.1	Breast, pancreas, sarcoma, you name it, we've got you covered.
0:50.5	Available on our app, so you can review anytime, anywhere.
1:29.1	Group discounts are available. Enjoy the episode and dominate the day. Hi, everyone, and welcome back to another episode with your behind-the-knife surgical oncology team. So this is the start of a new BTK surgical oncology season, and we're excited to have two new members to the team, and I'll let them introduce themselves. Unfortunately, Conner's unable to join us this season, but we wish him the best of luck as he starts his time as a staff. Let's start with introductions, and then we'll kick off our case for today on Fiochromo-Satomas. Hi, everyone, I'm Joe Broderick. I'm in my research year at Brookermie Medical Center. I'm between my second and third year of training. I'm Gailen Gist. I'm also in between my second and third year of training, currently
1:35.0	in my research year as well. Hi, I'm Elizabeth Barberi. You guys know me from last season. I'm a general
1:41.0	surgeon now in the UK, but I plan on applying to surgical oncology in a couple of years.
1:47.2	Hi, I'm Lexi Adams. I'm a fellow MD Anderson.
1:51.1	I'm Tim Bruin. I'm a staff surgical oncologist at Brooke Army Medical Center.
1:55.5	And then we have one other staff surgical oncologist, Dr. Daniel Nelson, who unfortunately won't be able to join us today,
2:01.2	but we look forward to hearing from him in future episodes.
2:04.5	Okay, let's get started.
2:07.4	Galen, you're seeing a 40-year-old man referred for an incidental left adrenal mass found on CT during a word
2:13.0	up for kidney stones. You have him the referral that he has also been complaining of
2:16.9	episodic headaches
2:17.7	and diapheresis, but no other information. What else do you want to know from the history and
2:22.3	physical exam? I'd start by asking about symptoms that you may have from a mass in each
2:29.2	part of the adrenal gland. For example, I'd ask about symptoms of cordyneal excesses, aldosterone excessive sex
	...

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