Pheochromocytoma signs symptoms diagnosis
investigations treatment and management. Pheochromocytoma is a rare tumor of Adrenal glands
Pheochromocytoma Symptoms Diagnosis Treatment
Pheochromocytomais an important cause of secondary
Hypertension. We have adnenal gland located at upper portion of each kidney. It is devided into
adrenal cortex and adrenal medulla. Pheochromocytoma is a tumor of Adrenal Medulla. Normal function
of adrenal medulla is to produce epinephrine or adrenaline. Which is responsible for controlling
bloodpressure and to help cope withstressful situations.
Symptoms of Pheochromocytoma
So majority of symptoms of pheochromocytoma are due to excess secreation of adrenaline from adrenal
medulla. Most patients of pheochromocytoma have recurrent episodes of headache, sweating and a
feeling of high anxiety. The following symptoms are listed from the most common to the least
sweating Episodes (generalized)
heart palpitatios (tachycardia and palpitations)
nervousness (feelings of impending death)
Pain in the lower chest or upper abdomen
Nausea (with or without nausea)
These symptomsmay come by situations which causes pressure over tumor like physical activity,
exercise, defecation, anesthesia, or change in body position.
Who should be examined for Pheochromocytoma
Those who have uncontrolled hypertension
Those who have age between 40 and 60 Those who are already taking 4 antihypertensive drugs but bloodpressure is not controlable.
Those who have episodes of above symptoms
Cause of pheochromocytoma is unknown, however some forms of this tumor runs in families like, a-Multiple endocrine neoplasia, type II (MEN-II). In addition to a
pheochromocytoma, people with MEN-II also have thyroid cancer. Other forms of MEN-II include
pheochromocytoma with thyroid cancer and hyperparathyroidism (MEN-IIA), and
pheochromocytoma with thyroid cancer and tumors of nerves in the eyes lips,
mouth and digestive tract (MEN-IIB). b-Neurofibromatosis 1 (NF1). Pheochromocytomas can occur in a small percentage of people with
NF1, a syndrome that includes multiple tumors in the skin (neurofibromas), pigmented skin
spots, tumors of the optic nerve of the eye, and bone diseases.
c-Von Hippel-Lindau (VHL) disease. People with this rare multisystem disorder are
at high risk of pheochromocytoma brain eye and kidney tumors.
Most pheochromocytomas are benign tumors and they dont spread to other parts of
body however some forms do show metastasis (spread) to other parts of body like lungs, bones and
brains. Usually only one gland is involved however this tumor can be present in both adrenal
Blood and Urine tests: We perform blood and urine tests to diagnose
pheochromocytoma. 24 hr urine collection is tested for epinephrine, norepinephrine and
dopamine. This test is called VMA. Idea is just to check level of epinephrine and its
metabolites in urine. If these are detected in urine in excess quantity, then tumor is
Abdominal scan. Now you
have diagnosed tumor by blood and urine tests, after that to find out
location of tumor, do Ultrasound, CT scan of abdomen.
Complications: If high bloodpressure remained uncontrolled it may lead to
complications of heart failure, infarction, cerebrovascular accident, vision damage and
First treatment is to control high bloodpressure with medication like Alpha Blockers and
Beta Blockers. When epinephrine is secreated by this tumor it acts on alpha and beta
receptors present on heart andblood vessels, result is vasoconstriction and
increase heart rate. Now if if we take drugs like alpha blocker and beta blocker, epinephrine
will be blocked by these drugs to act on these receptors so result is vasodilation and slow
heart rate. Common Alpha blockers are Prazosin (Minipress), Terazosin (Hytrin)
Phenoxybenzamine( Dibenzaline). Common Beta Blockers are Atenolol(Tenormin),
Carvedilol(Carveda), Metoprolol(Mepressor), Inderal.
Treatment of choice for this tumor is Surgery. After removal of this gland by surgery,
bloodpressure becomes normal with a day. There are two
types of surgeries. General and Laproscopic surgery. However Surgery is not an option
for those tumors which show metastasis to other parts of body. For that we use chemotherapy
Whenever you have high bloodpressure with any symptom, don't ignore it, you
may be the patient of Pheochromocytoma. Always contact your Doctor.
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Suzamara from LOCNtQSh
Toprol-XL (metoprolol) for Mitral Valve Prolapse: I was diagnosed with mitarl valve prolapse syndrome my senior year in college, resulting in a medical discharge from the Army rather than commissioning as an officer. I was blacking out, fainting, and my activity tolerance dropped dramatically as the condition progressed. Metoprolol was prescribed for me to help regulate my heart rate it worked great for that. I didn't feel the palpitations and heart racing with minimal activity. Downside was that my blood pressure was already low so being on this medication made my blood pressure drop even lower. Doctors eventually put me on MIDODRINE which constricts my blood vessels causing an increase in blood pressure. The combination works great!GD Star Ratingloading...
Posted at 9:51:am 06/02/12
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