Pheochromocytoma is a rare endocrine disease in which there is a production of a large amount of catecholamines (adrenaline and similar hormones) by a tumor which is usually benign and is often located in the adrenal glands.


However, sometimes this tumor is located outside the adrenal glands somewhere else in the abdomen or even in other parts of the body.


Occasionally, this tumor may be malignant.  



Symptoms of Pheochromocytoma



There is a long list  of symptoms of pheochromocytoma.


Usually symptoms occur in episodes, but may be present all the times.


Attacks of severe headaches, heart palpitations and excessive perspiration in the presence of high blood pressure is the usual combination of symptoms of pheochromocytoma.


Other symptoms include nervousness, anxiety and flushing of skin.


Severe high blood pressure in a young person is another manifestation of pheochromocytoma.


High blood pressure is present in most patients with pheochromocytoma. However, in some patients, blood pressure is normal.



     Diagnosis of Pheochromocytoma



Diagnosis of pheochromocytoma is a difficult one.


Many other common diseases such as thyroid disease, panic attacks and menopause syndrome can give rise to similar symptoms as those of pheochromocytoma.


A systematic, thorough evaluation by an endocrinologist is the best way to diagnose this rare, but a very important disease.


Biochemical Testing include:


24-hour urine collection for metanephrines, nor-metanephrines and free catecholamines


Blood level of free catecholamines



Localization of the tumor:


Only after the biochemical tests are clearly positive does a search for the location of the tumor begin. The tumor is usually located in one of the adrenal glands. Therefore, a CT scan or an MRI scan of adrenal glands is carried out to locate the tumor.

Sometimes, more extensive imaging studies have to be done in order to locate the tumor.



 Treatment of Pheochromocytoma



Treatment is most often surgical removal of the tumor.


Treatment before, during and soon after surgery is crucial and must be carried out by an endocrinologist. Otherwise, serious complications and even death can take place.


An experienced anesthesiologist and an experienced surgeon are extremely important in the surgery of a pheochromocytoma patient.




This article was written by Sarfraz Zaidi, MD, FACE. Dr. Zaidi specializes in Diabetes, photoEndocrinology and Metabolism.



Dr. Zaidi is a former assistant Clinical Professor of Medicine at UCLA and Director of the Jamila Diabetes and Endocrine Medical Center in Thousand Oaks, California.


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