Validation of the pheochromocytoma of adrenal gland scaled score (PASS) grading system: A retrospective double-centered cross-sectional study

PASS reliably identifies a low-risk subgroup, supporting its use as a screening tool to reduce unnecessary surveillance. However, its ability to predict malignant behavior is limited by subjective criteria and inter-observer variation. PASS should therefore be applied within a multimodal framework incorporating molecular markers. Prospective studies are needed to refine prognostic accuracy.