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SDHA-Deficient, Biochemically Silent Pheochromocytoma: A Case Report (ENDO 2025) - "Notably, α-blocker (doxazosin) initiation markedly improved symptoms, raising clinical suspicion. Even in the absence of classical biochemical markers, pheochromocytoma should remain a key diagnostic consideration when clinical suspicion and imaging findings are suggestive. This case reinforces that normal catecholamine levels do not exclude the diagnosis, particularly in tumors with intermittent secretion or confounding factors such as clonidine use. SDHA-negative tumors, though often somatic and biochemically silent, are not necessarily benign."

Case report • Clinical • Late-breaking abstract • Endocrine Cancer • Nephrology • Neuroendocrine Tumor • Oncology • Renal Calculi • Solid Tumor • SDHA • SDHB

"Biochemical Storm In Silence: An Incidentally Discovered Pheochromocytoma With Life-threatening Potential" (ENDO 2025) - "24-hour urine collection further confirmed biochemical activity with normetanephrines 1724 mcg/24h (ref: 122-676), total metanephrines 1859 mcg/24h (ref: 224-832), and metanephrine 135 mcg/24h (ref: 90-315), over a urine volume of 2815 mL confirming the diagnosis of a biochemically active pheochromocytoma.The patient was pre-treated with titrated alpha-blockade using doxazosin, followed by beta-blockade, and underwent successful laparoscopic adrenalectomy...This case highlights the deceptive nature of biochemically active yet asymptomatic pheochromocytomas. Left undetected, such tumors pose a silent but serious risk for sudden cardiovascular events. Routine biochemical screening of adrenal incidentalomas remains crucial."

Late-breaking abstract • Endocrine Cancer • Heart Failure • Hypertension • Lung Cancer • Myocardial Infarction • Oncology • Pain • Solid Tumor

Non concordant side in concomitant Mild Autonomous Cortisol Secretion and Primary Aldosteronism: How should we prioritize treatment? (ENDO 2025) - "His medication regimen included Nifedipine XL 90 mg daily, Carvedilol 12.5 mg twice daily, Doxazosin 2 mg daily, Clonidine 0.1 mg daily, Eplerenone 100 mg twice daily, Losartan 50 mg daily, and Potassium 60 mEq daily...A 1 mg-dexamethasone suppression (DST) test revealed an elevated cortisol level (6.6 mcg/dL) and an appropriate dexamethasone level (255 ng/dL), consistent with Mild Autonomous Cortisol Secretion (MACS)... While surgical adrenalectomy may reverse cardiac remodeling in patients with PA and concurrent MACS, there is limited guidance on how to prioritize treatment when hormone excess originates from different adrenal glands. In such cases, clinical judgment and an individualized approach are essential, along with optimal medical management to mitigate long-term complications and risks."

Discordant • Adrenal Cortex Carcinoma • Cardiovascular • Congestive Heart Failure • Cushing’s Disease • Endocrine Cancer • Endocrine Disorders • Fatigue • Heart Failure • Hypertension • Metabolic Disorders • Musculoskeletal Diseases • Myocardial Infarction • Oncology • Orthopedics • Solid Tumor

Adrenal Vein Sampling and Surgical Outcomes in Mild Autonomous Cortisol Secretion: A Case Series (ENDO 2025) - "Dexamethasone suppression cortisol value was 5.7, and patient demonstrated no clinical features of overt Cushing's syndrome...Hypertension medications included amlodipine/benazepril 10-40mg, clonidine 0.1mg twice a day, and hydralazine 10mg 3 times a day...By 5/2023, BP continued improving to 129/78, BMI decreased to 29.7 and medications included amlodipine/benazepril 10-40mg, hydralazine 50mg 3 times daily, and doxazosin 4mg.Case 2:55yo male with a right adrenal nodule (1.0 × 0.6 cm)...At 2 months post-op, BP was well controlled on only nifedipine 30mg and doxazosin 4mg once daily...AVS guided adrenalX in MACS resulted in BP improvement and stable BMI, with varying degrees of antihypertensive reduction. AVS remains a promising tool for guiding surgical decisions in adrenal nodules with subclinical cortisol excess. With additional research the full potential of AVS in guiding adrenalX may be realized."

Clinical • Anemia • Cardiovascular • Cushing’s Disease • Endocrine Disorders • Hematological Disorders • Hypertension • Hypoglycemia • Pain

Endogenous Suppression of Prolactinoma Hypersecretion by a Dopamine Secreting Paraganglioma (ENDO 2025) - "He was started on alpha blockade with doxazosin and underwent successful resection of the mediastinal mass...He was started on cabergoline, which suppressed prolactinagain...In our case, the pituitary pathology showed PIT1 staining but was negative for prolactin. Immature PIT1-lineage PitNETs are less differentiated, possess variable hormone immunostaining and secretion, and tend to be relatively larger and more aggressive."

Endocrine Cancer • Endocrine Disorders • Neuroendocrine Tumor • Oncology • Pituitary Gland Carcinoma • Solid Tumor • GATA3 • NF1 • SDHB • SDHC • SDHD • SYP

An Unusual Case of Catecholamine-Secreting Carotid Body Paraganglioma (ENDO 2025) - "She was started on doxazosin 2 mg and atenolol 25 mg oral daily for symptom control. HNPGLs are rarely associated with catecholamine hypersecretion. The prevalence of clinically significant catecholamine secreting HNPGLs has been estimated to be 7.7%-9.2%. However, this patient has bilateral carotid body PGLs with distinct metabolic activity."

Clinical • Cough • Endocrine Cancer • Endocrine Disorders • Gastrointestinal Disorder • Metabolic Disorders • Musculoskeletal Pain • Neuroendocrine Tumor • Oncology • Otorhinolaryngology • Pain • Respiratory Diseases • Solid Tumor • SYP

A Presentation of Euglycemic DKA Precipitated by Paraganglioma (ENDO 2025) - "Due to insurance issues, she had stopped her diabetes regimen of Jardiance and Ozempic eight months prior...She was discharged on Doxazosin 1 mg at bedtime for alpha blockade... This is the first reported case documenting a presentation of euglycemic DKA triggered by a paraganglioma. The patient had discontinued her SGLT-2 inhibitor and had no other etiology for the disease trigger. Excessive normetanephrines can contribute to lipolysis and impaired pancreatic beta cell function, leading to euglycemic DKA."

Cardiovascular • Diabetes • Endocrine Cancer • Endocrine Disorders • Hypertension • Metabolic Disorders • Oncology • Pain • Solid Tumor • Type 2 Diabetes Mellitus • SSTR

Bilateral Pheochromocytoma with Variant of Uncertain Significance in Rare MAX Gene (ENDO 2025) - "Plasma metanephrine was measured to be 22.20 (0-0.49 pmol/L), epinephrine was 4,715 (< 330 pmol/L), and norepinephrine was 23,283 (1050-4800 pmol/L). Given high likelihood of bilateral pheochromocytoma, the patient was initiated on Doxazosin for alpha blockade requiring up to 16mg twice daily...Genetic testing (Invitae) was positive for variant of uncertain significance (VUS) in the MAX gene with low risk for mutation.Conclusion Few cases of bilateral pheochromocytoma secondary to MAX gene mutations have been documented in the literature; therefore, continued documentation and genetic testing is necessary. At this time, further research will be needed to assess clinical presentation, management strategies, association with syndromes, and effects due to MAX gene mutation."

Endocrine Cancer • Endocrine Disorders • Nephrology • Oncology • Renal Disease • Solid Tumor • MAX

Metyrosine: An Unconventional Approach to Managing a Pheochromocytoma (ENDO 2025) - "She was transitioned from clevidipine to doxazosin which was up titrated to achieve a target blood pressure of 90 mmHg standing to induce orthostasis. She was seen 1 month post-surgery with normal ambulatory blood pressures. This case favors the safe use of metyrosine in the peri operative management of pheochromocytoma and should be considered for patients with an elevated risk of surgical complications."

Cardiovascular • Endocrine Cancer • Fatigue • Hematological Disorders • Hypertension • Oncology • Pain • Solid Tumor • Subarachnoid Hemorrhage

Epinephrine-Secreting Paraganglioma: A Rare Retroperitoneal Mass Case (ENDO 2025) - "Started on doxazosin, then beta blocker, high fluid intake, and scheduled for exploratory laparotomy. Paragangliomas secreting mostly epinephrine are seen in about 2 people per million, for which this is a very rare presentation, and they lead to hypertension, headache and palpitations, as in our patient. This case highlights the importance of biochemical testing prior to imaging, to avoid hypertensive crisis, the importance of surgical exploration despite imaging localization, as tumor found on right side instead of left as imaging showed, as well as the varied presentation of paragangliomas."

Clinical • Cardiovascular • Dyslipidemia • Essential Tremor • Hypertension • Movement Disorders • Musculoskeletal Pain • Oncology • Pain • Solid Tumor

Two for One: A Rare Case of Composite Pheochromocytoma and Ganglioneuroma (ENDO 2025) - "She was started on doxazosin 2mg twice daily and metoprolol 25mg daily in preparation for surgery... Composite pheochromocytomas constitute less than 3% of adrenal gland tumors with the ganglioneuroma subtype being the most prevalent neurogenic component2. Pheochromocytomas and composite pheochromocytomas are clinically, biochemically, and radiographically similar. The diagnosis is typically confirmed through histopathological examination after surgical resection of the tumor."

Clinical • Adrenal Cortex Carcinoma • Back Pain • Brain Cancer • Cardiovascular • Endocrine Cancer • Genito-urinary Cancer • Hypertension • Musculoskeletal Pain • Oncology • Pain • Solid Tumor

Large Pheochromocytoma and Successful Twin Pregnancy: Case Report (ENDO 2025) - "Management included doxazosin (titrated to 6 mg/day) for alpha-blockade, followed by metoprolol succinate to control heart rate. This case highlights the importance of early distinction between PHEO/PGL and hypertensive disorders of pregnancy. MRI without gadolinium and biochemical testing are pivotal for diagnosis. Alpha-blockade followed by beta-blockade remains the cornerstone of preoperative management, with doxazosin preferred for its safety profile in pregnancy."

Case report • Clinical • Aesthetic Medicine • Anesthesia • Cardiovascular • Endocrine Cancer • Gynecology • Hypertension • Oncology • Pain • Renal Disease • Solid Tumor

Radiographic Mimicry: A Case of an Incidental Paraganglioma First Diagnosed as a Renal Artery Aneurysm (ENDO 2025) - "She was pre-treated with doxazosin and metoprolol before undergoing successful resection of the paraganglioma and radical nephrectomy... Paragangliomas can present a diagnostic challenge as they can resemble other lesions including, rarely, vascular malformations. To our knowledge, this case is the first to describe a paraganglioma mimicking a renal artery aneurysm. When such lesions demonstrate atypical characteristics (such as growth over time) rarer pathologies such as paragangliomas may need to be considered as they require a multidisciplinary approach for appropriate treatment."

Clinical • Cardiovascular • Endocrine Cancer • Endocrine Disorders • Endometrial Adenocarcinoma • Endometrial Cancer • Hypertension • Neuroendocrine Tumor • Oncology • Solid Tumor

Incidental Papillary Thyroid Cancer in Primary Hyperparathyroidism: A Case Series (ENDO 2025) - "Peri-operatively he had hypertension and was managed with Doxazosin and Enalaprilat. It is unclear if factors such as calcium level or the presence of a malignant parathyroid nodule is associated with incidental PTC in patients with PH."

Clinical • Back Pain • Cardiovascular • Endocrine Cancer • Endocrine Disorders • Fatigue • Genetic Disorders • Hypertension • Metabolic Disorders • Musculoskeletal Pain • Oncology • Pain • Solid Tumor • Thyroid Gland Carcinoma • Thyroid Gland Papillary Carcinoma

Urinary Bladder Paraganglioma With POT1 and RECQL4 Mutations Almost Missed by Ga-68 DOTATATE PET/CT (ENDO 2025) - "Spironolactone therapy improved blood pressure (BP) control; however, BP spikes continued along with headaches occasionally associated with voiding/bowel movements. Medications were amlodipine 10 mg/day, eplerenone 50 mg BID, nebivolol 5 mg/day, doxazosin 2 mg nightly... Bladder paragangliomas pose a diagnostic challenge. As illustrated in this case, Ga68-DOTATATE PET/CT initially missed this lesion due to the urinary excretion of the tracer highlighting the need for other imaging modalities when considering bladder PGLs. Further studies examining whether POT1 or REQL4 mutations might be pathogenic for (urinary) PGLs are warranted."

Bladder Cancer • Cardiovascular • Colonic Polyps • Endocrine Cancer • Endocrine Disorders • Follicular Lymphoma • Gastroenterology • Hematological Malignancies • Hodgkin Lymphoma • Hypertension • Lymphoma • Neuroendocrine Tumor • Oncology • Pain • Solid Tumor • Thyroid Gland Carcinoma • Thyroid Gland Follicular Carcinoma • POT1 • RECQL4 • SDHB • SYP • TP63

Metastatic Pheochromocytoma and Neuroendocrine Breast Cancer in a Young Woman (ENDO 2025) - "Doxazosin 1 mg nightly and a high sodium diet were started and slowly increased to 5 mg every 12 hours over 14 days preop. Metoprolol tartrate was added after adequate alpha blockade... Cases of concurrent pheochromocytoma and neuroendocrine breast cancer remain rare. Few case studies show metastatic pheochromocytoma to the breast. Both pheochromocytoma and neuroendocrine breast cancer have been associated with several familial conditions, including Von-Hippel-Lindau, neurofibromatosis 1, and MEN2."

Clinical • Metastases • Breast Cancer • Cardiovascular • Diabetes • Endocrine Cancer • Genetic Disorders • Hormone Receptor Positive Breast Cancer • Hypertension • Neuroendocrine Carcinoma • Neuroendocrine Tumor • Neurofibromatosis • Oncology • Pain • Solid Tumor • Von Hippel-Lindau Syndrome • PGR

"Benign Paraganglioma as a Cause of Catecholamine Surge: Diagnostic and Therapeutic Challenges" (ENDO 2025) - "He was started on doxazosin and carvedilol before surgery...Postoperatively, he required nicardipine and nitroglycerin infusions for blood pressure control...Surgery is the primary treatment, with intraoperative crises managed by agents like nitroprusside or nicardipine... Paragangliomas are rare but significant causes of secondary hypertension. Despite being benign, functional paragangliomas pose considerable intra- and postoperative risks, requiring meticulous management and lifelong follow-up to monitor for recurrence or metastasis."

Acute Kidney Injury • Cardiovascular • Diabetes • Hypertension • Hypoglycemia • Hypotension • Metabolic Disorders • Nephrology • Oncology • Pain • Psychiatry • Pulmonary Disease • Renal Disease • Solid Tumor • Type 2 Diabetes Mellitus

Paraganglioma-Induced Catecholamine Crisis Presenting with Cardiomyopathy (ENDO 2025) - "He had evidence of demand ischemia and congestive heart failure with X-ray evidence of Kerley B lines.Hormonal workup revealed elevated serum epinephrine at 35,390 pg/mL (ref 10-200), norepinephrine at 40,808 pg/mL (ref 80-520), chromogranin A at 862 ng/mL (ref <103), serum metanephrines at 49.5 nmol/L (ref <0.49) and normetanephrines at 39.9 nmol/L (ref <0.8)...He was later switched to alpha blockade (doxazosin, titrated to 8 mg twice a day) followed by beta blockade...Plavix was held and he was placed on intravenous antiplatelet (P2Y12) inhibitor, cangrelor, until the first surgical incision...Alpha before beta-blockade is crucial to prevent unopposed alpha-adrenergic activity. However, surgical resection is the definitive treatment.This case highlights the profound effects of long-standing catecholamine excess on cardiometabolic health and the success of post-operative outcomes when a complex paraganglioma surgery is performed at a tertiary care center with a..."

Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Diabetes • Endocrine Cancer • Heart Failure • Hypertension • Metabolic Disorders • Myocardial Ischemia • Neuroendocrine Carcinoma • Neuroendocrine Tumor • Oncology • Solid Tumor • Type 2 Diabetes Mellitus

Delayed Diagnosis of Pheochromocytoma: A Six-Year Journey of Intermittent Hypertensive Crises (ENDO 2025) - "Patient was started on alpha blockers including Doxazosin and Prazosin with only partial relief in her symptoms. Additionally, it highlights the importance of testing during an episode of adrenergiccrisis. Successful surgical intervention and management offer hope for patients with complex, intermittent medical presentation."

Acute Coronary Syndrome • Cardiovascular • Endocrine Cancer • Hypertension • Mood Disorders • Neuroendocrine Tumor • Oncology • Pain • Psychiatry • Solid Tumor

Recurrent Pheochromocytoma and Mediastinal Mass in a Patient with SDHD-Associated Hereditary Paraganglioma-Pheochromocytoma Syndrome (ENDO 2025) - "Urine catecholamine testing revealed elevated norepinephrine (498 mcg/24 hours, normal 15-100 mcg/24 hours) and dopamine (1940 mcg/24 hours, normal 52-480 mcg/24 hours) but normal epinephrine levels (<7 mcg/24 hours, normal 2-24 mcg/24 hours)...The patient developed hypertension, for which doxazosin was initiated... Recurrent pheochromocytomas are uncommon; however, they are most frequently observed in the context of SDHD mutations, which confer an increased predisposition to the development of paragangliomas and other neuroendocrine tumors, as demonstrated in this patient. These findings underscore the importance of genetic testing and close surveillance in patients with a history of pheochromocytoma, particularly those with a family history of similar diagnoses, to enable early detection and management of recurrence or associated tumors."

Clinical • Cardiovascular • Endocrine Cancer • Hypertension • Neuroendocrine Tumor • Oncology • Solid Tumor • SDHD

Diagnostic Facade: A Case of ESRD Complicating Pheochromocytoma Diagnosis (ENDO 2025) - "Patient received ten days of alpha blockade with doxazosin 8 mg twice a day; metoprolol 12.5 mg twice a day was added three days prior to surgery for beta blockade... This case illustrates how ESRD may complicate the diagnosis of pheochromocytoma. In this patient, worsening hypertension attributed to his renal disease likely delayed the diagnosis of pheochromocytoma. Although in ESRD MN and NMN are typically elevated, they remain within 1.5 times the reference range unless a catecholamine-producing tumor is present."

Clinical • Cardiovascular • Chronic Kidney Disease • Endocrine Cancer • Hypertension • Nephrology • Oncology • Renal Disease • Solid Tumor

Diabetes Improvement After Asymptomatic Large Pheochromocytoma Surgical Intervention in a Patient with Colon Cancer: A Case Report (ENDO 2025) - "The patient was started on doxazosin for possible pheochromocytoma...Following surgery, the patient felt well, and his blood pressure was well-controlled on lisinopril alone...He stopped insulin and did not resume glipizide and maintain good control of diabetes on metformin alone (blood glucose consistently less 200 mg/dl). This case highlights the incidental discovery and asymptomatic nature of a large pheochromocytoma in a patient undergoing evaluation for another malignancy. The removal of the pheochromocytoma led to improved glycemic control, demonstrating the role of catecholamine excess in exacerbating diabetes."

Case report • Clinical • Adrenal Cortex Carcinoma • Cardiovascular • Colon Cancer • Colorectal Cancer • Diabetes • Endocrine Cancer • Endocrine Disorders • Hypertension • Metabolic Disorders • Nephrology • Oncology • Pain • Renal Disease • Solid Tumor • Type 2 Diabetes Mellitus

Cystic Pheochromocytoma in a Pregnant Female (ENDO 2025) - "She was initiated on alpha blockade with doxazosin and nifedipine for additional blood pressure control. Pheochromocytomas in pregnancy can also present another diagnostic challenge as symptoms are often non-specific and attributed to pre-eclampsia or pregnancy related hypertension. Due to high maternal and fetal mortality risk nearing 50%, it is crucial for clinicians to be aware of such entity to recognize and treat promptly."

Cardiovascular • CNS Disorders • Endocrine Cancer • Gynecology • Hypertension • Migraine • Mood Disorders • Oncology • Pain • Psychiatry • Solid Tumor

Bilateral Pheochromocytomas in Neurofibromatosis Type 1 (ENDO 2025) - "The patient was prescribed prazosin and underwent left adrenalectomy with improvement of hypertension...He was started on doxazosin prior to total right adrenalectomy...Post-operatively, the patient was started on physiologic dose of hydrocortisone and fludrocortisone...This case underscores the importance of considering pheochromocytomas even in patients who present with atypical signs without Menard's triad, or those who are diagnosed with genetic conditions that are not typically associated with pheochromocytomas. Timely and appropriate testing, along with prompt diagnosis and management is crucial to preventing life-threatening hypertensive crises."

Cardiovascular • Endocrine Cancer • Genetic Disorders • Hypertension • Neurofibromatosis • Oncology • Pain • Solid Tumor • NF1

From Seizure to Diagnosis: Pheochromocytoma in Neurofibromatosis Type 1 (ENDO 2025) - "In ICU, he received levetiracetam and nifedipine for seizure and blood pressure management...He was transitioned to doxazosin 2mg and carvedilol 3.125mg twice daily for BP control and preoperative preparation...Clinicians caring for patients with NF1 should maintain a high index of suspicion for pheochromocytoma in symptomatic NF1 patients, particularly those with headaches, palpitations, or uncontrolled hypertension. Timely recognition and screening are critical to prevent the cardiovascular and neurological complications from undiagnosed pheochromocytoma."

Cardiovascular • CNS Disorders • Diabetes • Endocrine Cancer • Epilepsy • Genetic Disorders • Hypertension • Immunology • Metabolic Disorders • Neurofibromatosis • Oncology • Pain • Solid Tumor • NF1