REVIEW article
Front. Endocrinol.
Sec. Cancer Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1671486
This article is part of the Research TopicBone Metastases in Endocrine Cancers: Advances in Diagnosis, Treatment, and PreventionView all 8 articles
Bone metastases in pheochromocytomas and paragangliomas: a narrative review of presentation, diagnosis and management
Provisionally accepted
Jorge Eduardo Contreras-Saldarriaga1*
Melissa Loaiza Alzate2- 1University of Antioquia, Medellín, Colombia
- 2Fundacion Universitaria San Martin - Sede Medellin, Sabaneta, Colombia
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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
Keywords: Pheochromacytoma, Paraganglioma, Bone Metastases, neuroendocrine tumor, Skeletal-related event (SRE)
Received: 23 Jul 2025; Accepted: 22 Oct 2025.
Copyright: © 2025 Contreras-Saldarriaga and Alzate. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jorge Eduardo Contreras-Saldarriaga, jecs.4815@gmail.com
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