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2026, Número S1

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Rev Mex Anest 2026; 49 (S1)


Feocromocitoma: optimización preoperatoria y estabilización hemodinámica durante la manipulación tumoral

Domínguez-Cherit JG

Idioma: Español
Referencias bibliográficas: 40
Paginas: 277-280
Archivo PDF: 849.85 Kb.


FRAGMENTO

GENERALIDADES, INCIDENCIA
Y FISIOPATOLOGÍA

El feocromocitoma (FEO) es un tumor neuroendocrino derivado de las células cromafines de la médula suprarrenal que secreta catecolaminas (norepinefrina (NE), epinefrina (E), dopamina) de forma autónoma. Los tumores extrasuprarrenales reciben el nombre de paraganglioma (PGL); en conjunto se denominan PPGL. La clasificación OMS 2022 considera todos los PPGL potencialmente malignos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, GrebeSK, Murad MH, et al. Pheochromocytoma and paraganglioma: anEndocrine Society clinical practice guideline. J Clin Endocrinol Metab.

  2. 2014;99:1915-1942.2. Nolting S, Bechmann N, Taieb D, Beuschlein F, Fassnacht M, KroissM, et al. Personalized management of pheochromocytoma andparaganglioma. Endocr Rev. 2022;43:199-239.

  3. Naranjo J, Dodd S, Martin YN. Perioperative management ofpheochromocytoma. J Cardiothorac Vasc Anesth. 2017;31:1427-1439.

  4. Lord MS, Augoustides JG. Perioperative management ofpheochromocytoma: focus on magnesium, clevidipine, and vasopressin.J Cardiothorac Vasc Anesth. 2012;26:526-531.

  5. Lindstrom EJ, Attaallah AF. Novel use of clevidipine for intraoperativeblood pressure management in patients with pheochromocytoma. AANAJ. 2016;84:343-347.

  6. Luis-García C, Arbonés-Aran E, Teixell-Aleu C, Lorente-Poch L, Trillo-Urrutia L. Clevidipine for hypertension treatment in pheochromocytomasurgery. Rev Esp Anestesiol Reanim (Engl Ed). 2018;65:225-228.

  7. Buonanno A, Bruzzese D, Battagliese M, et al. Clevidipine for themanagement of hypertension in the perioperative settings: a systematicreview. Front Med (Lausanne). 2025;12:1562681.

  8. Ma M, Zhang X, Yu X, Ma L. Perioperative management and outcomeof catecholamine-induced Takotsubo and dilated cardiomyopathy inpheochromocytoma and paraganglioma. J Cardiothorac Vasc Anesth.2025 May;39:1275-1281.

  9. Augoustides JG, Abrams M, Berkowitz D, Fraker D. Vasopressin forhemodynamic rescue in catecholamine-resistant vasoplegic shockafter resection of massive pheochromocytoma. Anesthesiology.2004;101:1022-1024.

  10. Weingarten TN, Cata JP, O’Hara JF, Prybilla DJ, Pike TL, Thompson GB,et al. Comparison of two preoperative medical management strategiesfor laparoscopic resection of pheochromocytoma. Urology. 2010;76:508.e6–508.e11.

  11. Pacak K. Preoperative management of the pheochromocytoma patient.J Clin Endocrinol Metab. 2007;92:4069-4079.

  12. Ramakrishna H. Pheochromocytoma resection: current concepts inanesthetic management. J Anaesthesiol Clin Pharmacol. 2015;31:317-323.

  13. Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, BeckmanJA, Bozkurt B, et al. 2014 ACC/AHA guideline on perioperativecardiovascular evaluation and management of patients undergoingnoncardíac surgery. Circulation. 2014;130:e278-e333.

  14. Araujo-Castro M, García-Centeno R, López-García MC, et al.Multidisciplinary practice guidelines for the diagnosis and treatment ofpheochromocytomas and paragangliomas. Eur J Intern Med. 2021;91:98-117.

  15. Holt NF, Silverman DG, Prasad R, et al. Pheochromocytomas andparagangliomas: considerations for the anesthesiologist. AnesthesiolClin. 2020;38:95-113.

  16. Jogini V, Bhargavan Nair B, Paluvoi N, et al. Preoperative preparationand intraoperative management of pheochromocytoma/paraganglioma.Ann Card Anaesth. 2021;24:153-160.

  17. Lentschener C, Gaujoux S, Tesniere A, Dousset B. Point of controversy:perioperative care of patients undergoing pheochromocytoma removal.Eur J Endocrinol. 2011;165:365-373.

  18. Bravo EL, Tagle R. Pheochromocytoma: state-of-the-art and futureprospects. Endocr Rev. 2003;24:539-553.

  19. Lenders JW, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma.Lancet. 2005;366:665-675.

  20. Kline JP. Use of clevidipine for intraoperative hypertension caused by anundiagnosed pheochromocytoma: a case report. AANA J. 2010;78:288-290.

  21. Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, GrebeSK, Murad MH, et al. Pheochromocytoma and paraganglioma: anEndocrine Society clinical practice guideline. J Clin Endocrinol Metab.

  22. 2014;99:1915-1942.2. Nolting S, Bechmann N, Taieb D, Beuschlein F, Fassnacht M, KroissM, et al. Personalized management of pheochromocytoma andparaganglioma. Endocr Rev. 2022;43:199-239.

  23. Naranjo J, Dodd S, Martin YN. Perioperative management ofpheochromocytoma. J Cardiothorac Vasc Anesth. 2017;31:1427-1439.

  24. Lord MS, Augoustides JG. Perioperative management ofpheochromocytoma: focus on magnesium, clevidipine, and vasopressin.J Cardiothorac Vasc Anesth. 2012;26:526-531.

  25. Lindstrom EJ, Attaallah AF. Novel use of clevidipine for intraoperativeblood pressure management in patients with pheochromocytoma. AANAJ. 2016;84:343-347.

  26. Luis-García C, Arbonés-Aran E, Teixell-Aleu C, Lorente-Poch L, Trillo-Urrutia L. Clevidipine for hypertension treatment in pheochromocytomasurgery. Rev Esp Anestesiol Reanim (Engl Ed). 2018;65:225-228.

  27. Buonanno A, Bruzzese D, Battagliese M, et al. Clevidipine for themanagement of hypertension in the perioperative settings: a systematicreview. Front Med (Lausanne). 2025;12:1562681.

  28. Ma M, Zhang X, Yu X, Ma L. Perioperative management and outcomeof catecholamine-induced Takotsubo and dilated cardiomyopathy inpheochromocytoma and paraganglioma. J Cardiothorac Vasc Anesth.2025 May;39:1275-1281.

  29. Augoustides JG, Abrams M, Berkowitz D, Fraker D. Vasopressin forhemodynamic rescue in catecholamine-resistant vasoplegic shockafter resection of massive pheochromocytoma. Anesthesiology.2004;101:1022-1024.

  30. Weingarten TN, Cata JP, O’Hara JF, Prybilla DJ, Pike TL, Thompson GB,et al. Comparison of two preoperative medical management strategiesfor laparoscopic resection of pheochromocytoma. Urology. 2010;76:508.e6–508.e11.

  31. Pacak K. Preoperative management of the pheochromocytoma patient.J Clin Endocrinol Metab. 2007;92:4069-4079.

  32. Ramakrishna H. Pheochromocytoma resection: current concepts inanesthetic management. J Anaesthesiol Clin Pharmacol. 2015;31:317-323.

  33. Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, BeckmanJA, Bozkurt B, et al. 2014 ACC/AHA guideline on perioperativecardiovascular evaluation and management of patients undergoingnoncardíac surgery. Circulation. 2014;130:e278-e333.

  34. Araujo-Castro M, García-Centeno R, López-García MC, et al.Multidisciplinary practice guidelines for the diagnosis and treatment ofpheochromocytomas and paragangliomas. Eur J Intern Med. 2021;91:98-117.

  35. Holt NF, Silverman DG, Prasad R, et al. Pheochromocytomas andparagangliomas: considerations for the anesthesiologist. AnesthesiolClin. 2020;38:95-113.

  36. Jogini V, Bhargavan Nair B, Paluvoi N, et al. Preoperative preparationand intraoperative management of pheochromocytoma/paraganglioma.Ann Card Anaesth. 2021;24:153-160.

  37. Lentschener C, Gaujoux S, Tesniere A, Dousset B. Point of controversy:perioperative care of patients undergoing pheochromocytoma removal.Eur J Endocrinol. 2011;165:365-373.

  38. Bravo EL, Tagle R. Pheochromocytoma: state-of-the-art and futureprospects. Endocr Rev. 2003;24:539-553.

  39. Lenders JW, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma.Lancet. 2005;366:665-675.

  40. Kline JP. Use of clevidipine for intraoperative hypertension caused by anundiagnosed pheochromocytoma: a case report. AANA J. 2010;78:288-290.




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