Differences in management and outcomes between pheochromocytomas and sympathetic paragangliomas

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Purpose The primary aim was to study the differences between pheochromocytomas (PCC) and sympathetic paragangliomas (PGL) in management and short- and long-term outcomes. Methods This was a retrospective study of 220 patients that had undergone surgery for PCC or PGL and had been managed during the period 2005–2025 at the Department of Endocrinology, Karolinska University Hospital. Patient data were collected from electronic medical journals. Results Patients with PCC compared to PGL had a longer duration of preoperative treatment with alpha-adrenergic receptor antagonist (50.0 vs. 34.0 days, p = 0.014) and shorter hospital stay (4.0 vs. 7.0 days, p < 0.001). Patients with PCC presented more often with dysglycemia (42.2% vs. 17.6%, p = 0.012), and glucose improved to a greater extent as well after surgery (84.2% vs. 33.3%, p = 0.033). Patients with PGL were more affected by new related tumors (recurrence, metastases, or metachronous tumor) during the follow-up time (27.8% vs. 11.0%; p = 0.019). Conclusions There are many similarities between PCC and PGL; however, patients with PGL had a somewhat worse prognosis regarding short- and long-term outcomes, including longer length of stay at the hospital, risk for new associated tumors, and less positive effects on dysglycemia.