FEOCROMOCITOMA E PARAGANGLIOMAS: DIAGNÓSTICO INTEGRADO, ABORDAGEM ENDÓCRINO-ONCOLÓGICA E ESTRATÉGIAS TERAPÊUTICAS PERSONALIZADAS
DOI:
https://doi.org/10.71248/vcmv9348Palavras-chave:
Feocromocitoma, Paraganglioma, Testes genéticos, Metanefrinas, Medicina de precisãoResumo
Esta revisão de escopo teve como objetivo mapear as evidências publicadas entre 2021 e 2026 sobre o diagnóstico integrado, a abordagem endócrino-oncológica e as estratégias terapêuticas personalizadas para pacientes com feocromocitoma e paraganglioma (PPGL). Seguiram-se o método do Joanna Briggs Institute e o checklist PRISMA-ScR. A busca foi feita na MEDLINE, via PubMed, e incluiu revisões sistemáticas, metanálises, diretrizes, ensaios clínicos e estudos multicêntricos. Dos 135 registros identificados, 65 estudos foram incluídos. Os mais frequentes abordaram terapias sistêmicas, perfil clínico e prognóstico e investigação genética. As evidências apontam o papel central das metanefrinas plasmáticas, ainda com margem para ajustar pontos de corte, e o valor da testagem genética para estratificar risco, sobretudo nas variantes de pseudo-hipóxia e em SDHB. Também indicam boa acurácia da PET/TC com [18F]FDOPA, segurança da cirurgia minimamente invasiva mesmo em tumores grandes e atividade de radiofármacos, inibidores de tirosina-quinase e belzutifano na doença metastática. Persistem lacunas, como a ausência de ensaios randomizados sobre o preparo pré-operatório e terapias sistêmicas e a escassez de dados latino-americanos. Conclui-se que o manejo do PPGL depende de uma integração multiprofissional guiada pelo genótipo.
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