Zhou Yifan, Tai Yanghao, Shang Jiwen
Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.
Department of Ambulatory Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Eur J Surg Oncol. 2025 Aug;51(8):110144. doi: 10.1016/j.ejso.2025.110144. Epub 2025 May 10.
Pheochromocytoma (PHEO) is an uncommon neuroendocrine tumor originating from the chromaffin cells of the adrenal medulla. These tumors are capable of producing and releasing substantial amounts of catecholamine (CA) hormones. Individuals with PHEO often experience transient blood pressure fluctuations, headaches, and palpitations, among other symptoms. In extreme cases, they may develop severe complications, including cardiovascular and cerebrovascular incidents, myocardial disorders, and gastrointestinal issues. At the advanced stage, PHEO can affect multiple organs, potentially leading to pheochromocytoma crisis. However, the clinical manifestations of pheochromocytoma may be diverse. Some patients have no typical triad of headache, palpitations, and sweating, and are not accompanied by obvious clinical symptoms or signs. There are only abnormalities in imaging and biochemical indicators, which will pose a challenge for early diagnosis. The primary treatment options for PHEO encompass surgical and non-surgical approaches. In contrast to many other adrenal pathologies, there is currently no consensus on the optimal surgical versus non-surgical management of PHEO. Laparoscopic surgery, as opposed to traditional open surgery, offers numerous benefits. However, whether retroperitoneal or transperitoneal laparoscopic adrenalectomy remains controversial. Da Vinci robot-assisted adrenalectomy has the advantages of highly precise operation and excellent hemostasis capabilities. The day surgery management model for adrenalectomy procedures has proven to be both safe and feasible. However, current research on its long - term effectiveness and wide - scale application still has limitations. Additionally, the application of the Senhance robot in urology, particularly in adrenalectomy, has seen relatively little investigation thus far. In terms of non-surgical treatment for pheochromocytoma, chemotherapy, radionuclide therapy, targeted therapy and immunotherapy, as well as radiofrequency ablation and microwave ablation chemotherapy have all advanced significantly. This article aims to review the latest advancements in the treatment of pheochromocytoma.
嗜铬细胞瘤（PHEO）是一种罕见的神经内分泌肿瘤，起源于肾上腺髓质的嗜铬细胞。这些肿瘤能够产生和释放大量儿茶酚胺（CA）激素。患有嗜铬细胞瘤的个体经常经历短暂的血压波动、头痛和心悸等症状。在极端情况下，他们可能会出现严重并发症，包括心血管和脑血管事件、心肌疾病以及胃肠道问题。在疾病晚期，嗜铬细胞瘤可影响多个器官，可能导致嗜铬细胞瘤危象。然而，嗜铬细胞瘤的临床表现可能多种多样。一些患者没有典型的头痛、心悸和出汗三联征，且不伴有明显的临床症状或体征。仅在影像学和生化指标上存在异常，这将对早期诊断构成挑战。嗜铬细胞瘤的主要治疗选择包括手术和非手术方法。与许多其他肾上腺疾病不同，目前对于嗜铬细胞瘤的最佳手术与非手术治疗尚无共识。与传统开放手术相比，腹腔镜手术有诸多益处。然而，后腹腔镜或经腹腔镜肾上腺切除术仍存在争议。达芬奇机器人辅助肾上腺切除术具有操作高度精确和止血能力出色的优点。肾上腺切除术的日间手术管理模式已被证明是安全可行的。然而，目前关于其长期有效性和广泛应用的研究仍有局限性。此外，迄今为止，Senhance机器人在泌尿外科的应用，尤其是在肾上腺切除术中的应用研究相对较少。在嗜铬细胞瘤的非手术治疗方面，化疗、放射性核素治疗、靶向治疗和免疫治疗以及射频消融和微波消融化疗都有了显著进展。本文旨在综述嗜铬细胞瘤治疗的最新进展。
