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What is the most common symptom of pheochromocytoma?

Reviewed on 6/5/2020

What Is Pheochromocytoma?

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 

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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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Reviewed on 6/5/2020
References
Source: http://emedicine.medscape.com/article/124059-overview

https://www.ncbi.nlm.nih.gov/books/NBK7002/
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