{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:17:04Z","timestamp":1792459024303,"version":"4.5.0"},"reference-count":36,"publisher":"Bioscientifica","issue":"7","license":[{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["erc.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,26]]},"abstract":"<jats:p>Core needle biopsy (CNB) has been used with caution in pheochromocytoma and paraganglioma (PPGL) due to concerns about catecholamine-related complications. While it is unclear what scientific evidence supports this claim, it has limited the acquisition of biological samples for diagnostic purposes and research, especially in metastatic PPGL. We performed a systematic review and individual patient meta-analysis to evaluate the risk of complications after CNB in PPGL patients. The primary and secondary objectives were to investigate the risk of death and the occurrence of complications requiring intervention or hospitalization, respectively. Fifty-six articles describing 86 PPGL patients undergoing CNB were included. Of the patients (24\/71), 34% had metastases and 53.4% (31\/58) had catecholamine-related symptoms before CNB. Of the patients (14\/41), 34.1% had catecholamine excess testing prior to the biopsy. No CNB-related deaths were reported. Four patients (14.8%, 4\/27) experienced CNB-related complications requiring hospitalization or intervention. One case had a temporary duodenal obstruction caused by hematoma, two cases had myocardial infarction, and one case had Takotsubo cardiomyopathy. Eight patients (32%, 8\/25) had CNB-related catecholamine symptoms, mainly transient hypertension, excessive diaphoresis, tachycardia, or hypertensive crisis. The scientific literature does not allow us to make any firm conclusion on the safety of CNB in PPGL. However, it is reasonable to argue that CNB could be conducted after thorough consideration, preparation, and with close follow-up for PPGL patients with a strong clinical indication for such investigation.<\/jats:p>","DOI":"10.1530\/erc-22-0354","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T10:44:29Z","timestamp":1682505869000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":20,"title":["Risk of complications after core needle biopsy in pheochromocytoma\/paraganglioma"],"prefix":"10.1530","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8448-6754","authenticated-orcid":true,"given":"Liang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"\u00c5kerstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-8970","authenticated-orcid":true,"given":"Kazhan","family":"Mollazadegan","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Beuschlein","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Klinische Ern\u00e4hrung, Universit\u00e4tsspital Z\u00fcrich (USZ) and Univerist\u00e4t Z\u00fcrich (UZH), Zurich, Switzerland"},{"name":"Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3541-3767","authenticated-orcid":true,"given":"Karel","family":"Pacak","sequence":"additional","affiliation":[{"name":"Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt","family":"Skogseid","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joakim","family":"Crona","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of Endocrinological Investigation","first-page":"2545","article-title":"Protocol for presurgical and anesthetic management of pheochromocytomas and sympathetic paragangliomas: a multidisciplinary approach","volume":"44","author":"Araujo-Castro","year":"2021","unstructured":"Araujo-Castro MPascual-Corrales ENattero Chavez LMart\u00ednez Lorca AAlonso-Gordoa TMolina-Cerrillo JLorca \u00c1lvaro JM\u00ednguez Ojeda CRedondo L\u00f3pez SBarber\u00e1 Durb\u00e1n R, 2021Protocol for presurgical and anesthetic management of pheochromocytomas and sympathetic paragangliomas: a multidisciplinary approach. 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(https:\/\/doi.org\/10.1097\/MPA.0000000000001792)"},{"key":"bib11","series-title":"BMC Surgery","article-title":"Laparoscopic versus open surgery for pheochromocytoma: a meta-analysis","volume":"20","author":"Fu","year":"2020","unstructured":"Fu SQWang SYChen QLiu YTLi ZL & Sun T2020Laparoscopic versus open surgery for pheochromocytoma: a meta-analysis. BMC Surgery20 167. (https:\/\/doi.org\/10.1186\/s12893-020-00824-6)"},{"key":"bib12","series-title":"Endocrine","first-page":"171","article-title":"Immune signature of pheochromocytoma and paraganglioma in context of neuroendocrine neoplasms associated with prognosis","volume":"79","author":"Ghosal","year":"2023","unstructured":"Ghosal SVanova KHUher ODas SPatel MMeuter LHuynh TTJha ATalvacchio SKnue M, 2023Immune signature of pheochromocytoma and paraganglioma in context of neuroendocrine neoplasms associated with prognosis. Endocrine79171\u2013179. 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(https:\/\/doi.org\/10.1002\/bjs.1800720510)"},{"key":"bib19","series-title":"Journal of Hypertension","first-page":"1443","article-title":"Genetics, diagnosis, management and future directions of research of phaeochromocytoma and paraganglioma: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension","volume":"38","author":"Lenders","year":"2020","unstructured":"Lenders JWMKerstens MNAmar LPrejbisz ARobledo MTaieb DPacak KCrona JZelinka TMannelli M, 2020Genetics, diagnosis, management and future directions of research of phaeochromocytoma and paraganglioma: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension. Journal of Hypertension381443\u20131456. 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(https:\/\/doi.org\/10.1007\/BF00351270)"},{"key":"bib22","series-title":"Journal of Vascular and Interventional Radiology","first-page":"670","article-title":"Radiofrequency ablation and biopsy of metastatic pheochromocytoma: emphasizing safety issues and dangers","volume":"20","author":"Mamlouk","year":"2009","unstructured":"Mamlouk MDvanSonnenberg EStringfellow GSmith D & Wendt A2009Radiofrequency ablation and biopsy of metastatic pheochromocytoma: emphasizing safety issues and dangers. Journal of Vascular and Interventional Radiology20670\u2013673. (https:\/\/doi.org\/10.1016\/j.jvir.2009.01.031)"},{"key":"bib23","series-title":"AJR. American Journal of Roentgenology","first-page":"113","article-title":"Fine-needle aspiration of catecholamine-producing adrenal masses: a possibly fatal mistake","volume":"145","author":"McCorkell","year":"1985","unstructured":"McCorkell SJ & Niles NL1985Fine-needle aspiration of catecholamine-producing adrenal masses: a possibly fatal mistake. AJR. 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