{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:54:53Z","timestamp":1790751293552,"version":"4.1.0"},"reference-count":84,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":271,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology Research and Practice"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Pheochromocytoma is an uncommon neuroendocrine tumor with myriad nonspecific clinical presentations. If not recognized and treated, it is associated with the development of target organ damage and complications such as myocarditis, cardiomyopathy, cerebrovascular accidents, and diabetes mellitus, among numerous others. The pheochromocytoma diagnosis is based on biochemical proof of catecholamine excess followed by imaging localization of the tumor. Patients with newly diagnosed pheochromocytoma should be seen by a multidisciplinary perioperative team, including the anesthesiologist, operating surgeon, endocrinologist, and cardiologist. Perioperative antihypertensive therapy should be instituted prior to adrenal resection to allow for cardiovascular recovery and to hopefully mitigate the hypertensive response to laryngoscopy and tumor manipulation. The anesthesiologist must be prepared to manage both intraoperative hypertension, hypotension, and glycemic disturbances, among other possible complications. Patients with previously undiagnosed pheochromocytoma who present for unrelated surgery represent a high\u2010risk group. Once intraoperatively suspected, priority should be given to immediate stabilization, cessation of surgery when feasible, and close communication with the surgical team regarding whether the procedure should be aborted, limited, or continued based on the urgency of the operation and the patient\u2019s clinical status. In most cases, nonessential surgery should be aborted. The postoperative level of care should be based on intraoperative patient courses and institutional protocols and guidelines to monitor and manage postresection hypoglycemia and vasoplegia, when they occur. This narrative review aims to provide practicing anesthesiologists with an updated, practical framework for the perioperative recognition and management of pheochromocytoma. We integrate contemporary evidence with anesthesia\u2010specific decision\u2010making, including the management of catecholamine\u2010induced cardiovascular dysfunction, perioperative fluid and vasoactive therapy, medication\u2010triggered crises, and a dedicated approach to previously undiagnosed pheochromocytoma presenting during unrelated surgery.<\/jats:p>","DOI":"10.1155\/anrp\/4406992","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:57:01Z","timestamp":1790747821000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pheochromocytoma Across the Perioperative Course: Current Concepts and Clinical Management"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1604-1053","authenticated-orcid":false,"given":"Aibek E.","family":"Mirrakhimov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Bashall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_16_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2023.07.027"},{"key":"e_1_2_16_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra1806651"},{"key":"e_1_2_16_3_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.4.7392"},{"key":"e_1_2_16_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2018.11.019"},{"key":"e_1_2_16_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-024-02850-w"},{"key":"e_1_2_16_6_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcemcr\/luad061"},{"key":"e_1_2_16_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.11.1427"},{"key":"e_1_2_16_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/ans.19257"},{"key":"e_1_2_16_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9082435"},{"key":"e_1_2_16_10_2","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2.1.59"},{"key":"e_1_2_16_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0039-6109(05)70412-6"},{"key":"e_1_2_16_12_2","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/ca.20706","article-title":"Experience in Identifying the Venous Drainage of the Adrenal Gland During Laparoscopic Adrenalectomy","volume":"21","author":"Parnaby C. N.","year":"2008","journal-title":"Clinical Anatomy"},{"key":"e_1_2_16_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ucl.2025.01.001"},{"key":"e_1_2_16_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2005.04.006"},{"key":"e_1_2_16_15_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.05.0370"},{"key":"e_1_2_16_16_2","doi-asserted-by":"publisher","DOI":"10.1124\/pr.56.3.1"},{"key":"e_1_2_16_17_2","doi-asserted-by":"publisher","DOI":"10.1023\/a:1011572617314"},{"key":"e_1_2_16_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2018.01.015"},{"key":"e_1_2_16_19_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa965"},{"key":"e_1_2_16_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(20)30314-4"},{"key":"e_1_2_16_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2011.02.002"},{"key":"e_1_2_16_22_2","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1161\/HYP.0000000000000084","article-title":"Resistant Hypertension: Detection, Evaluation, and Management","volume":"72","author":"Carey R. M.","year":"2018","journal-title":"Hypertension"},{"key":"e_1_2_16_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31916"},{"key":"e_1_2_16_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2009.09.022"},{"key":"e_1_2_16_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-015-1738-z"},{"key":"e_1_2_16_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-023-03492-7"},{"key":"e_1_2_16_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.123.21902"},{"key":"e_1_2_16_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-008-9105-8"},{"key":"e_1_2_16_29_2","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.ijsu.2014.04.001","article-title":"Current Concepts of Pheochromocytoma","volume":"12","author":"Conzo G.","year":"2014","journal-title":"International Journal of Surgery"},{"key":"e_1_2_16_30_2","doi-asserted-by":"publisher","DOI":"10.1530\/erc-15-0221"},{"key":"e_1_2_16_31_2","doi-asserted-by":"publisher","DOI":"10.1080\/10641963.2022.2132012"},{"key":"e_1_2_16_32_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1500681"},{"key":"e_1_2_16_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-6175.2002.01452.x"},{"key":"e_1_2_16_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(20)30363-6"},{"key":"e_1_2_16_35_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3020"},{"key":"e_1_2_16_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2017-223993"},{"key":"e_1_2_16_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659120908413"},{"key":"e_1_2_16_38_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.788644"},{"key":"e_1_2_16_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/03000605241270655"},{"key":"e_1_2_16_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.70241"},{"key":"e_1_2_16_41_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.4103\/0975-3583.95375","article-title":"Pheochromocytoma With Inferior Vena Cava Thrombosis: An Unusual Association","volume":"3","author":"Kota S. K.","year":"2012","journal-title":"Journal of Cardiovascular Disease Research"},{"key":"e_1_2_16_42_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498"},{"key":"e_1_2_16_43_2","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnae001"},{"key":"e_1_2_16_44_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-1-200901060-00006"},{"key":"e_1_2_16_45_2","doi-asserted-by":"crossref","first-page":"970","DOI":"10.2214\/AJR.06.0827","article-title":"CT of Pheochromocytoma and Paraganglioma: Risk of Adverse Events With I.V. Administration of Nonionic Contrast Material","volume":"188","author":"Bessell-Browne R.","year":"2007","journal-title":"American Journal of Roentgenology"},{"key":"e_1_2_16_46_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.6010"},{"key":"e_1_2_16_47_2","first-page":"941","article-title":"The Effect of Alpha-Adrenergic Blockade on Cardiac Performance and Tissue Oxygen Delivery During Excision of Pheochromocytoma","volume":"94","author":"Roizen M. F.","year":"1983","journal-title":"Surgery"},{"key":"e_1_2_16_48_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-013-1933-9"},{"key":"e_1_2_16_49_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.joacp_71_18"},{"key":"e_1_2_16_50_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz188"},{"key":"e_1_2_16_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12084"},{"key":"e_1_2_16_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aat.2011.05.007"},{"key":"e_1_2_16_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(78)90772-9"},{"key":"e_1_2_16_54_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2005.04156.x"},{"key":"e_1_2_16_55_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab130"},{"key":"e_1_2_16_56_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2014-208683"},{"key":"e_1_2_16_57_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.02.023"},{"key":"e_1_2_16_58_2","doi-asserted-by":"publisher","DOI":"10.5387\/fms.58.78"},{"key":"e_1_2_16_59_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-06777-z"},{"key":"e_1_2_16_60_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-016-0216-7"},{"key":"e_1_2_16_61_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2253-14-90"},{"key":"e_1_2_16_62_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200011000-00013"},{"key":"e_1_2_16_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2023.06.016"},{"key":"e_1_2_16_64_2","doi-asserted-by":"publisher","DOI":"10.21037\/gs-20-783"},{"key":"e_1_2_16_65_2","doi-asserted-by":"publisher","DOI":"10.4103\/0970-1591.44277"},{"key":"e_1_2_16_66_2","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200730110-00004"},{"key":"e_1_2_16_67_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje-07-0778"},{"key":"e_1_2_16_68_2","doi-asserted-by":"publisher","DOI":"10.1530\/edm-22-0306"},{"key":"e_1_2_16_69_2","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1001\/archsurg.141.8.771","article-title":"Selective Use of Steroid Replacement After Adrenalectomy: Lessons From 331 Consecutive Cases","volume":"141","author":"Shen W. T.","year":"2006","journal-title":"Archives of surgery"},{"key":"e_1_2_16_70_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.3544"},{"key":"e_1_2_16_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(75)90060-0"},{"key":"e_1_2_16_72_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960060307"},{"key":"e_1_2_16_73_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1441-2772(23)01830-6"},{"key":"e_1_2_16_74_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-025-05153-x"},{"key":"e_1_2_16_75_2","article-title":"Management of Hypertensive Emergencies and Urgencies: Narrative Review","volume":"20","author":"Jolly H.","year":"2021","journal-title":"Postgraduate Medical Journal"},{"key":"e_1_2_16_76_2","doi-asserted-by":"publisher","DOI":"10.1097\/aln.0b013e318210483d"},{"key":"e_1_2_16_77_2","doi-asserted-by":"publisher","DOI":"10.1002\/anr3.12201"},{"key":"e_1_2_16_78_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000024984"},{"key":"e_1_2_16_79_2","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2015.3484"},{"key":"e_1_2_16_80_2","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/514714"},{"key":"e_1_2_16_81_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2007.04.015"},{"key":"e_1_2_16_82_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199006000-00022"},{"key":"e_1_2_16_83_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11070936"},{"key":"e_1_2_16_84_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.593780"}],"container-title":["Anesthesiology Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/anrp\/4406992","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/anrp\/4406992","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/anrp\/4406992","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:57:03Z","timestamp":1790747823000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/anrp\/4406992"}},"subtitle":[],"editor":[{"given":"Srijoni","family":"Sengupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":84,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/anrp\/4406992"],"URL":"https:\/\/doi.org\/10.1155\/anrp\/4406992","archive":["Portico"],"relation":{},"ISSN":["1687-6962","1687-6970"],"issn-type":[{"value":"1687-6962","type":"print"},{"value":"1687-6970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4406992"}}