What Is the Most Common Symptom of Pheochromocytoma?

What Is Pheochromocytoma?

Pheochromocytomas are rarely cancerous so for the most part, life expectancy is normal once a tumor is removed.

A pheochromocytoma is a rare, usually benign, tumor that can cause life-threatening high blood pressure (hypertension). The tumors produce too much catecholamine hormone [such as norepinephrine (noradrenaline), epinephrine (adrenaline), and dopamine] which can cause episodes of high blood pressure. In about 10% of cases, pheochromocytomas are malignant (cancerous) but they can be cured if they are surgically removed. 

What Are Symptoms of Pheochromocytoma?

Pheochromocytoma spells typically include four main symptoms:

These spells follow a pattern:

  • Frequency of spells varies from several times daily to once a month
  • The duration of spells varies from seconds to hours 
  • Over time, spells usually occur more often and increase in severity as the tumor grows 

Other symptoms that may occur during a pheochromocytoma spell include:

What Causes Pheochromocytoma?

About one-third of cases of pheochromocytoma are caused by an inherited genetic mutation. The other two-thirds of cases do not have a known cause (idiopathic).

Pheochromocytoma spells may be caused by certain triggers, such as:

  • Stress
  • Physical activity
  • Certain medications such as beta-blockers or anesthetics 
  • Surgery
  • Childbirth
  • Massage
  • Pressure on the tumor
  • Foods that contain large amounts of the amino acid tyramine, such as chocolate, cheese, and red wine

How Is Pheochromocytoma Diagnosed?

Tests used to diagnose pheochromocytoma include:

  • Plasma metanephrine testing 
  • 24-hour urine collection for catecholamines and metanephrines
  • Imaging studies
  • Other studies to rule out other conditions that have similar symptoms: 
    • Blood tests
      • Parathyroid hormone level 
      • Calcium level 
    • Screening for mutations in the ret proto-oncogene  
    • Genetic testing 
    • Consultation with an ophthalmologist to rule out retinal angiomas 

What Is the Treatment for Pheochromocytoma?

The preferred treatment for pheochromocytoma is surgical removal of the tumor, which usually cures the condition. 

Pre-operatively, patients may need to take medications to reduce blood pressure to prepare for surgery, such as: 

  • Alpha-blockers 
  • Beta-blockers
  • Calcium channel blockers
  • Angiotensin receptor blockers (ARBs)

Patients may also be advised to consume a high salt diet prior to surgery. 

Pheochromocytomas are usually not malignant (cancerous), but if they are, they may be treated with:

What Are Complications of Pheochromocytoma?

Complications of pheochromocytomas include:

What Is the Life Expectancy for Pheochromocytoma?

Pheochromocytomas are rarely cancerous so for the most part, life expectancy is normal once a tumor is removed.
If pheochromocytoma is not diagnosed and treated promptly and the tumor is cancerous, the survival rate is diminished. 

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Source: http://emedicine.medscape.com/article/124059-overview