Background: Many
options exist for diagnosis and management of the patient with pheochromocytoma,
with practices varying among different centers and recommendations more often
based on institutional experience than on evidence-based medicine. Progress on
the latter front is limited by the rarity of the tumor and the subsequent fragmented
nature of studies, most of which involve small numbers of patients or case reports.
Nevertheless, the forming of international consortia and multicenter studies
to pool patient material, resources and experience is leading to increased progress.
Improvements in diagnosis, localization, management and treatment of pheochromocytomas
have also been fueled by leaps in our understanding of the genetics and biology
of these tumors, coupled with advances in analytical chemistry, genomics, molecular
biology, biotechnology and nuclear medicine. Ineffective treatments for malignant
tumors, inadequate methods to distinguish malignant from benign disease, and lack
of consensus on how to apply recent scientific and medical advances to improve
diagnosis and patient management remain important unresolved problems. An
important feature of ISP2005 centered around several breakout sessions held to
stimulate discussion on problem issues that could benefit from resolution in the
form of recommendations, or where possible some form of consensus from leaders
in the field. Under the guidance of impartial moderators, participants were asked
to formulate recommendations that were subsequently discussed and agreed upon
at a final general session of the Symposium where all attendees could be present.
The outcome of these breakout sessions, including recommendations that
arose from discussions, has been published in several monographs as part of the
Proceedings of
the meeting. A condensed version of the material in those monographs is also being
published in review form elsewhere: Pacak,
K. et al. Pheochromocytoma: recommendations for clinical practice from the first
international symposium. Nature: Clinical Practice, Endocrinology & Metabolism
"in press", 2006.
Those recommendations
and related details are also presented here representing the combined efforts
of PRESSOR members.
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Background