Genetics and imaging of pheochromocytomas and paragangliomas: current update.

Authors:
Venkata S Katabathina
Venkata S Katabathina
University of Texas Health Science Center at San Antonio
United States
Hamid Rajebi, MD
Hamid Rajebi, MD
University of Texas Health San Antonio
San Antonio, TX | United States
Melissa Chen
Melissa Chen
Northwestern University Feinberg School of Medicine
United States
Carlos S Restrepo
Carlos S Restrepo
The University of Texas Health Science Center at San Antonio
United States
Umber Salman
Umber Salman
University of Texas Health Science Center at San AntonioSan Antonio
Raghu Vikram
Raghu Vikram
The University of Texas MD Anderson Cancer Center
Christine O Menias
Christine O Menias
Mallinckrodt Institute of Radiology
United States
Srinivasa R Prasad
Srinivasa R Prasad
University of Texas Health Science Center at San Antonio
United States

Abdom Radiol (NY) 2019 May 8. Epub 2019 May 8.

University of Texas MD Anderson Cancer Center, Houston, USA.

Pheochromocytomas (PCCs) and paragangliomas (PGLs) are rare, heterogeneous neuroendocrine neoplasms of the autonomous nervous system of chromaffin cell origin that may arise within the adrenal medulla (PCCs) or the sympathetic and parasympathetic paraganglia (PGLs). Currently referred to by the umbrella term pheochromocytomas-paragangliomas (PPGLs), these distinct tumors are characterized by specific histopathology as well as biological and clinical profiles. PPGLs may occur as part of hereditary syndromes (40% of cases) or as sporadic tumors. Currently, there are 12 different hereditary syndromes with characteristic genetic abnormalities, at least 15 well-characterized driver genes and distinct tumor metabolic pathways. Based on the Cancer Genome Atlas (TCGA) taxonomic schemata, PPGLs have been classified into three main clusters of specific genetic mutations and tumor pathways with clinical, biochemical, and prognostic implications. Imaging plays a pivotal role in the initial diagnosis, tumor characterization, evaluation of treatment response, and long-term surveillance. While MDCT and MRI help in the anatomic localization, SPECT, and PET using different radiotracers are crucial in the functional assessment of these tumors. Surgery, chemotherapy, and radiotherapy are currently available treatment options for PPGLs; antiangiogenic drugs are also being used in treating metastatic disease. Evolving knowledge regarding the different genetic abnormalities involved in the pathogenesis of PPGLs has identified potential therapeutic targets that may be utilized in the discovery of novel drugs.

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http://dx.doi.org/10.1007/s00261-019-02044-wDOI Listing
May 2019
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