Bone metastases in pheochromocytomas and paragangliomas: a narrative review of presentation, diagnosis and management

Background Bone metastases (BM) are a frequent and clinically relevant manifestation in patients with metastatic pheochromocytomas and paragangliomas (mPPGL). Objective This narrative review aims to summarize the current understanding of the pathophysiology, epidemiology, clinical presentation, complications, quality of life impact, and management of BM in mPPGL. Summary Bone and lymph nodes are among the most common metastatic sites in malignant PPGL. Skeletal involvement—particularly in paragangliomas—is associated with a high incidence of skeletal-related events (SREs), including pathological fractures, spinal cord compression, and pain. These complications lead to reduced mobility, loss of independence, and decreased survival. Advances in functional and anatomical imaging have improved detection, but optimal management remains complex and requires a multidisciplinary approach. Conclusion Recognizing patients at higher risk and understanding the biological mechanisms underlying bone dissemination are essential to optimize diagnosis, prevent SREs, and improve outcomes in this rare and challenging disease.

• Publication year

  2025

• Venue

  Frontiers in Endocrinology

• Publication date

  2025-11-05

• Fields of study

  Medicine

• Identifiers
  DOI 10.3389/fendo.2025.1671486PMID 41268153PMCID 12626828
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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