Clinical consensus guideline on the management of phaeochromocytoma and paraganglioma in patients harbouring germline SDHD pathogenic variants
Research output: Contribution to journal › Review article › Contributed › peer-review
Contributors
Abstract
Patients with germline SDHD pathogenic variants (encoding succinate dehydrogenase subunit D; ie, paraganglioma 1 syndrome) are predominantly affected by head and neck paragangliomas, which, in almost 20% of patients, might coexist with paragangliomas arising from other locations (eg, adrenal medulla, para-aortic, cardiac or thoracic, and pelvic). Given the higher risk of tumour multifocality and bilaterality for phaeochromocytomas and paragangliomas (PPGLs) because of SDHD pathogenic variants than for their sporadic and other genotypic counterparts, the management of patients with SDHD PPGLs is clinically complex in terms of imaging, treatment, and management options. Furthermore, locally aggressive disease can be discovered at a young age or late in the disease course, which presents challenges in balancing surgical intervention with various medical and radiotherapeutic approaches. The axiom-first, do no harm-should always be considered and an initial period of observation (ie, watchful waiting) is often appropriate to characterise tumour behaviour in patients with these pathogenic variants. These patients should be referred to specialised high-volume medical centres. This consensus guideline aims to help physicians with the clinical decision-making process when caring for patients with SDHD PPGLs.
Details
Original language | English |
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Pages (from-to) | 345-361 |
Number of pages | 17 |
Journal | The Lancet. Diabetes & endocrinology |
Volume | 11 |
Issue number | 5 |
Publication status | Published - May 2023 |
Peer-reviewed | Yes |
External IDs
PubMedCentral | PMC10182476 |
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Scopus | 85152526589 |
Keywords
Keywords
- Humans, Adrenal Gland Neoplasms/diagnosis, Germ-Line Mutation/genetics, Paraganglioma/diagnosis, Pheochromocytoma/diagnosis, Succinate Dehydrogenase/genetics, Practice Guidelines as Topic