Pheochromocytoma:

  • Rare, catecholamine-secreting tumor
  • 10% is malignant

Symptoms & Signs

Classically, it manifests with the classic triad: Headaches, Palpitations, Diaphoresis

Severe hypertension/ related complications:

  • Cardiovascular complications such as myocardial infarction and arrhythmias
  • Sudden death may occur in patients with undiagnosed tumors who undergo other surgeries or biopsy.
  • Precipitate hypertensive encephalopathy & cerebral hemorrhage.
  • Panic attacks

The following may also occur: Tremor, Nausea, Weakness, Anxiety, sense of doom, Epigastric pain, Constipation

Diagnosis:

  • 24-hour (urine-VMA
  • Plasma metanephrine metabolite of Epinephrine)
  • CT/MRI to locate tumor/ (MIBG scan)

Intervention:

  • Alpha-blocking agents

    • Prazosin (Minipress) to decrease BP
  • Beta-blocking agents

    • Inderal to control heart rate
  • Sedatives

  • Surgical resection of the tumor is the treatment of choice and usually cures the hypertension

An MIBG scan iodine-123 meta-iodobenzylguanidine

  • is commonly used for the detection of neuroendocrine tumors, such as neuroblastoma and pheochromocytoma.

  • It can also aid in the detection of carcinoid and medullary thyroid carcinoma