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Open research questions in Adrenal and Paraganglionic Tumors

101 gap statements mined from Adrenal and Paraganglionic Tumors papers in our 4.5M-paper local library, which holds 586 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Nevertheless, the lack of correspondence between the robust SSTs expression in PPGL and the limited clinical evaluation of SSAs remains unclear.

    Functional profiling of somatostatin receptors identifies somatostatin receptor subtype 2 as a vulnerability in Succinate Dehydrogenase SDHB-deficient pheochromocytomas and paragangliomas · 2026 · DOI

  • The study is limited to a single case of two monochorionic monoamniotic twin brothers. The study does not provide a large sample size or long-term follow-up.

    EL Tumor germinal pineal en gemelos monocoriónicos monoamnióticos adultos en UMAE 25, Monterrey Nuevo León. Reporte de caso y revisión bibliográfica. · 2026 · DOI

  • There is a lack of literature on germinal pineal tumors in adult patients. There is a need for a multidisciplinary approach for diagnosis and treatment.

    EL Tumor germinal pineal en gemelos monocoriónicos monoamnióticos adultos en UMAE 25, Monterrey Nuevo León. Reporte de caso y revisión bibliográfica. · 2026 · DOI

  • The size limit for robotic adrenalectomy is less clearly defined. There is a need for more research on the use of robotic adrenalectomy for large adrenal tumors.

    Robot-Assisted Adrenalectomy for a Giant Adrenal Myelolipoma: One of the Largest Tumors Removed by a Minimally Invasive Approach · 2026 · DOI

  • The mechanisms underlying ACC progression into a metastatic and lethal disease remain poorly understood. The evolutionary dynamics underpinning metastatic progression have remained unresolved.

    Genomic Catastrophe Defines the Evolutionary Trajectory of Adrenocortical Carcinoma · 2026 · DOI

  • Due to the small number of patients the applicability to all ACC tumours is limited. Furthermore, as all patients underwent surgery for their relapse, a selection of patients with a less aggressive disease process may have occurred. To mitigate these issues, we verified many of our findings using other published reports on ACC.

    Genomic Catastrophe Defines the Evolutionary Trajectory of Adrenocortical Carcinoma · 2026 · DOI

  • However, the association between ARGs and ACC has not been fully explored. The prognostic model based on six ARGs showed good discrimination in the training and validation cohorts, although the decrease in AUC values in the validation cohorts suggests a potential risk of overfitting and indicates that further validation in larger independent datasets is warranted.

    An anoikis-based risk model predicts outcomes and is associated with the immune microenvironment in adrenocortical carcinoma · 2026 · DOI

  • The association of nonmetastatic PPGLs with thromboembolic manifestations is rare and not well understood. The role of severe infectious etiologies in the development of consumptive coagulopathy in patients with paraganglioma is not well established.

    Retroperitoneal paraganglioma complicated by consumptive coagulopathy and severe Clostridioides difficile infection · 2026 · DOI

  • Fourth, the lack of standardization in staging protocols, imaging modalities, and systemic therapy regimens across the prolonged 17-year inclusion period may have introduced heterogeneity in recurrence detection.

    Clinical outcomes and prognostic factors after adrenalectomy for adrenal metastasis from hepatocellular carcinoma · 2026 · DOI

  • There is a lack of understanding of Carney complex in children. There is a need for more research on the genetic causes of Cushing's syndrome in children.

    Cushing’s syndrome and early growth hormone hypersecretion in a child with Carney complex: a case report · 2026 · DOI

  • Given the extremely limited number of reported cases, current evidence is insufficient to either support or refute the efficacy of mitotane for SAC, and more multicenter large-sample studies are urgently needed.

    Sarcomatoid adrenocortical carcinoma with aggressive disease course: a rare case report and literature review · 2026 · DOI

  • In this regard, alpha-emitting meta-astatobenzylguanidine labeled with astatine-211 (²¹¹At-MABG) has demonstrated encouraging non-clinical results in mice, yet its clinical potential remains unclear.

    First-in-human, open-label, single-arm phase 1 study of [211At] meta-astatobenzylguanidine in patients with pheochromocytoma or paraganglioma · 2026 · DOI

  • There is a lack of data on the surgical treatment of pheochromocytoma complicated by IVC tumor thrombosis. Prior work has described individual cases, but there is a need for larger series and more systematic evaluations.

    Surgical treatment of pheochromocytoma complicated by tumor thrombosis of the inferior vena cava: a post-hoc analysis and series of clinical cases · 2026 · DOI

  • Need for optimal medical preparation and rigorous intraoperative monitoring.

    PERIOPERATIVE MANAGEMENT OF PHEOCHROMOCYTOMA: A REPORT OF 5 CASES · 2026 · DOI

  • The study had a limited number of patients with PGL. The study did not investigate the underlying genetic variants of the tumors.

    Differences in management and outcomes between pheochromocytomas and sympathetic paragangliomas · 2026 · DOI

  • There is a limited number of studies directly comparing the differences in management and outcomes between PCC and PGL. The underlying genetic variants of the tumors and their impact on the presentation, management, and outcomes are not well understood.

    Differences in management and outcomes between pheochromocytomas and sympathetic paragangliomas · 2026 · DOI

  • There is a lack of comparison of the clinical characteristics of adrenal mass between adults and children.

    Comparison of clinical characteristics between children and adults with adrenal mass · 2026 · DOI

  • The genetic heterogeneity of PPGLs is not fully understood. The utility of WGS and OGM in select cases with uninformative germline panels is not well established. There is a need for comprehensive genetic testing panels for accurate diagnosis and management plans.

    Comprehensive Genomic Analysis in Hereditary Adrenal and Extra-Adrenal Paragangliomas · 2026 · DOI

  • Functional ganglioneuromas are exceptionally uncommon and can be difficult to diagnose. Imaging features of functional ganglioneuromas can mimic those of more aggressive tumors such as paragangliomas.

    Imaging in functional posterior mediastinal ganglioneuroma presenting with catecholamine-induced dilated cardiomyopathy · 2026 · DOI

  • Differentiating between benign and malignant adrenal tumors is crucial due to their significantly different prognoses. The diagnostic value of measuring CT values on non-contrast CT has been established, but approximately one-third of adrenal incidentalomas still have HU values >10.

    Habitat-radiomics combining multichannel 2.5D deep learning for differentiating adrenal adenomas from metastases using automatic segmentation: a multicenter study · 2026 · DOI

  • Limited to patients operated in the Department of Anesthesiology and Surgical Intensive Care of Ibn Rochd University Hospital, Casablanca.

    PERIOPERATIVE MANAGEMENT OF PHEOCHROMOCYTOMA: A REPORT OF 5 CASES · 2026 · DOI

  • Cervico-mediastinal ganglioneuroma is a rare entity with limited reported cases. Preoperative diagnosis is challenging due to overlapping radiological features with other cervicothoracic masses.

    Surgical management of cervico-mediastinal ganglioneuroma in a child: a case report · 2026 · DOI

  • The paper identifies a gap in the understanding of the association between phaeochromocytoma-induced catecholamine excess and brown adipose tissue accumulation. The paper highlights the importance of considering brown fat uptake in the diagnosis of phaeochromocytoma.

    Unusual Pattern of Brown Fat Uptake on 18 F-FDG PET/CT in a Case of Malignant Phaeochromocytoma · 2026 · DOI

  • Étude de la prévalence et de l'incidence du phéochromocytome ectopique. Évaluation de l'efficacité de la prise en charge des instabilités hémodynamiques peropératoires dans la réduction de la morbi-mortalité associée au phéochromocytome occulte.

    Prise en Charge Anesthésique et Chirurgicale d'un Phéochromocytome Ectopique de Découverte Fortuite : Un Cas Clinique Mauritanien · 2026 · DOI

  • La découverte en per opératoire de phéochromocytome représente une entité rare et de très mauvais pronostic. Il existe un besoin de sensibilisation des chirurgiens et anesthésistes aux risques de phéochromocytome lors de l'intervention sur une masse abdominale inexpliquée.

    Prise en Charge Anesthésique et Chirurgicale d'un Phéochromocytome Ectopique de Découverte Fortuite : Un Cas Clinique Mauritanien · 2026 · DOI

Most-cited papers in Adrenal and Paraganglionic Tumors

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Open questions raised by papers listed on this page include: (1) The lack of correspondence between the robust SSTs expression in PPGL and the limited clinical evaluation of SSAs remains unclear (“Functional profiling of somatostatin receptors identifies somatostatin receptor…”, 2026); (2) There is a lack of literature on germinal pineal tumors in adult patients (“EL Tumor germinal pineal en gemelos monocoriónicos monoamnióticos adultos en…”, 2026); (3) There is a need for more research on the use of robotic adrenalectomy for large adrenal tumors (“Robot-Assisted Adrenalectomy for a Giant Adrenal Myelolipoma: One of the…”, 2026); (4) The mechanisms underlying ACC progression into a metastatic and lethal disease remain poorly understood (“Genomic Catastrophe Defines the Evolutionary Trajectory of Adrenocortical…”, 2026); (5) The association between ARGs and ACC has not been fully explored (“An anoikis-based risk model predicts outcomes and is associated with the immune…”, 2026). 101 gap statements have been mined from Adrenal and Paraganglionic Tumors papers in our 4.5M-paper local library, which holds 586 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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