How do I install the Ppgl Partial Adrenalectomy Indication skill?

Run npx skillmds@latest add dromlakhani/ppgl-partial-adrenalectomy-indication in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

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Is Ppgl Partial Adrenalectomy Indication free to use?

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Who published Ppgl Partial Adrenalectomy Indication?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Ppgl Partial Adrenalectomy Indication by dromlakhani

Name: Ppgl Partial Adrenalectomy Indication
Rating: 4.2 (5 reviews)
Author: dromlakhani

Ppgl Partial Adrenalectomy Indication

This skill assesses whether partial adrenalectomy is indicated for pheochromocytoma and paraganglioma (PPGL) to preserve adrenal function in patients with familial PPGL syndrome, imaging showing bilateral adrenal tumors or high-risk genetics, or young PPGL patients desiring adrenal function preservation. Indication is considered for familial PCC, tumors ≤5 cm, or high risk of future contralateral adrenal lesions, requiring surgical expertise and informed consent regarding recurrence risk.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Partial Adrenalectomy Indication Assessment for PPGL

STEP 1 — Gather Information

Collect: family history of PPGL syndrome (VHL, MEN2, RET, SDHx), genetic testing results, imaging (CT/MRI) showing bilateral adrenal tumors or unilateral lesion with high-risk contralateral genetics, tumor size (≤5 cm vs >5 cm), patient age, patient preference for adrenal preservation, surgeon expertise in partial adrenalectomy, and documentation of informed consent discussion regarding recurrence and steroid dependence risk.

STEP 2 — Rule In / Rule Out

Is there a familial PPGL syndrome, bilateral adrenal tumors/high-risk genetics, tumor ≤5 cm, or a young patient desiring adrenal preservation? If yes, proceed to Step 3; if no, partial adrenalectomy is not indicated.

STEP 3 — Classify or Stratify

Classify as suitable for partial adrenalectomy if tumor ≤5 cm, surgeon has expertise in partial adrenalectomy, and informed consent obtained; otherwise classify as unsuitable (tumor >5 cm, insufficient expertise, or lack of consent).

STEP 4 — Decide

If suitable, proceed with partial adrenalectomy; if unsuitable, perform total adrenalectomy or consider alternative surgical approach.

Clinical Guardrails / Mimics / Pitfalls

Do not perform partial adrenalectomy in tumors >5 cm, in surgeons without specific expertise, without documented informed consent, or in sporadic PPGL lacking high-risk genetics/bilateral disease; avoid ignoring recurrence risk (ipsilateral tumor recurrence ~13%) and steroid dependence (23.5% postoperative).

Concrete Clinical Example

A 28‑year‑old patient with a known VHL pathogenic variant presents with a 4 cm left adrenal tumor and normal right adrenal gland; genetic counseling confirms high risk of contralateral lesion, the patient desires adrenal preservation, and an experienced endocrine surgeon is available. After informed consent discussing recurrence and steroid dependence risks, a left partial adrenalectomy is performed.

Source: Japan Endocrine Society Clinical Practice Guideline for the Diagnosis and Management of Pheochromocytoma and Paraganglioma 2025, Japan Endocrine Society, 2025, DOI:10.1507/endocrj.EJ25-0165

---name: ppgl-partial-adrenalectomy-indicationdescription: This skill assesses whether partial adrenalectomy is indicated for pheochromocytoma and paraganglioma (PPGL) to preserve adrenal function in patients with familial PPGL syndrome, imaging showing bilateral adrenal tumors or high-risk genetics, or young PPGL patients desiring adrenal function preservation. Indication is considered for familial PCC, tumors ≤5 cm, or high risk of future contralateral adrenal lesions, requiring surgical expertise and informed consent regarding recurrence risk.---# Partial Adrenalectomy Indication Assessment for PPGL## STEP 1 — Gather InformationCollect: family history of PPGL syndrome (VHL, MEN2, RET, SDHx), genetic testing results, imaging (CT/MRI) showing bilateral adrenal tumors or unilateral lesion with high-risk contralateral genetics, tumor size (≤5 cm vs >5 cm), patient age, patient preference for adrenal preservation, surgeon expertise in partial adrenalectomy, and documentation of informed consent discussion regarding recurrence and steroid dependence risk.## STEP 2 — Rule In / Rule OutIs there a familial PPGL syndrome, bilateral adrenal tumors/high-risk genetics, tumor ≤5 cm, or a young patient desiring adrenal preservation? If yes, proceed to Step 3; if no, partial adrenalectomy is not indicated.## STEP 3 — Classify or StratifyClassify as suitable for partial adrenalectomy if tumor ≤5 cm, surgeon has expertise in partial adrenalectomy, and informed consent obtained; otherwise classify as unsuitable (tumor >5 cm, insufficient expertise, or lack of consent).## STEP 4 — DecideIf suitable, proceed with partial adrenalectomy; if unsuitable, perform total adrenalectomy or consider alternative surgical approach.## Clinical Guardrails / Mimics / PitfallsDo not perform partial adrenalectomy in tumors >5 cm, in surgeons without specific expertise, without documented informed consent, or in sporadic PPGL lacking high-risk genetics/bilateral disease; avoid ignoring recurrence risk (ipsilateral tumor recurrence ~13%) and steroid dependence (23.5% postoperative).## Concrete Clinical ExampleA 28‑year‑old patient with a known VHL pathogenic variant presents with a 4 cm left adrenal tumor and normal right adrenal gland; genetic counseling confirms high risk of contralateral lesion, the patient desires adrenal preservation, and an experienced endocrine surgeon is available. After informed consent discussing recurrence and steroid dependence risks, a left partial adrenalectomy is performed.**Source:** Japan Endocrine Society Clinical Practice Guideline for the Diagnosis and Management of Pheochromocytoma and Paraganglioma 2025, Japan Endocrine Society, 2025, DOI:10.1507/endocrj.EJ25-0165

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