Treatment of Sympathetic Paraganglioma in Children and Adolescents with Localized, Resectable Disease
When sympathetic paraganglioma is diagnosed in a child or adolescent and the tumor is localized and surgically resectable — whether adrenal or extra-adrenal — the management pathway reflects both the pediatric context and the specific characteristics of the tumor.
This protocol applies to localized, resectable adrenal or extra-adrenal sympathetic paraganglioma in a child or adolescent, in the absence of metastatic or unresectable disease. The pediatric population requires dedicated surgical planning that accounts for tumor location, extent, and patient-specific risk factors.
Treatment Approach
Surgical resection with clear margins is the cornerstone of curative management for localized pediatric paraganglioma, with the specific operative technique determined by tumor location, size, local extent, and individual clinical risk factors — full technique selection criteria and hereditary-syndrome guidance are detailed in the complete protocol.
References
DOI: 10.1093/ejendo/lvaf239
- Surgical resection is the mainstay of curative treatment for localized pediatric PGL.
- Minimally invasive adrenalectomy (laparoscopic or robotic) is the preferred technique for localized tumors without evidence of invasion, provided it is performed in centers with expertise in pediatric endocrine and oncologic surgery.
- Open adrenalectomy is indicated when there is suspicion of local invasion, when tumors are anatomically complex, or when tumor size makes minimally invasive approaches technically challenging.
- Open resection remains standard in complex or high-risk locations.