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嗜铬细胞瘤和副神经节瘤的诊断与管理:临床医生指南

Diagnosis and Management of Pheochromocytomas and Paragangliomas: A Guide for the Clinician.

作者信息

Sharma Sona, Fishbein Lauren

机构信息

Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Duke University, Durham, North Carolina.

Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Rocky Mountain Regional Veteran's Administration Medical Center, Endocrinology Section, University of Colorado School of Medicine, Aurora, Colorado.

出版信息

Endocr Pract. 2023 Dec;29(12):999-1006. doi: 10.1016/j.eprac.2023.07.027. Epub 2023 Aug 15.

Abstract

OBJECTIVE

The aim of this review was to provide a practical approach for clinicians regarding the diagnosis and management of pheochromocytomas and paragangliomas (PPGLs).

METHODS

A literature search of PubMed was carried out using key words, including pheochromocytoma, paraganglioma, treatment, diagnosis, screening, and management. The discussion of diagnosis and management of PPGL is based on the evidence available from prospective studies when available and mostly from cohort studies, cross-sectional studies, and expert consensus.

RESULTS

PPGL are neuroendocrine tumors arising from the chromaffin cells of adrenal medulla and sympathetic and parasympathetic ganglia, respectively. PPGL can be localized or metastatic, and they may secrete catecholamines, causing a variety of symptoms and potentially catastrophic and lethal complications if left untreated. The rarity of these tumors along with heterogeneous clinical presentation often poses challenges for the diagnosis and management. PPGL can be associated with several familial syndromes which are important to recognize.

CONCLUSION

The last few years have witnessed an exponential growth in the knowledge around PPGL. This review aims at providing a comprehensive discussion of current concepts for clinicians regarding clinical presentation, diagnostic tools, and management strategies for PPGL.

摘要

目的

本综述的目的是为临床医生提供一种关于嗜铬细胞瘤和副神经节瘤(PPGLs)诊断与管理的实用方法。

方法

使用包括嗜铬细胞瘤、副神经节瘤、治疗、诊断、筛查和管理等关键词在PubMed上进行文献检索。PPGL诊断与管理的讨论基于前瞻性研究(如有)的现有证据,且大多来自队列研究、横断面研究和专家共识。

结果

PPGL是分别起源于肾上腺髓质嗜铬细胞以及交感和副交感神经节的神经内分泌肿瘤。PPGL可为局限性或转移性,它们可能分泌儿茶酚胺,导致各种症状,若不治疗可能引发灾难性和致命性并发症。这些肿瘤的罕见性以及临床表现的异质性常常给诊断和管理带来挑战。PPGL可与多种家族性综合征相关,认识到这一点很重要。

结论

在过去几年中,关于PPGL的知识呈指数级增长。本综述旨在为临床医生全面讨论PPGL的临床表现、诊断工具和管理策略等当前概念。

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