VHL and pheochromocytoma: Bilateral adrenalectomy is recommended for bilateral pheochromocytomas; however, the risk of adrenal insufficiency and the side effects of life long glucocorticoid replacement have led to certain centers performing adrenal cortex sparing resections particularly in the setting of genetic syndromes such as VHL and MEN2A where the risk of malignant tumors is low (325).