• Pheochromocytoma

    (Pheo; Adrenal Gland Tumor; Pheochromocytosis)

    Definition

    Pheochromocytoma is a tumor. It is made up of special adrenal gland cells. These cells secrete hormones such as epinephrine and norepinephrine. These hormones help to regulate the heart rate and blood pressure. The cells may secrete excessive amounts of the hormones. This results in periods of:
    Most of these tumors are benign (noncancerous). About 10% are malignant (cancerous). Most of the tumors grow on the adrenal glands. The glands are on top of the kidneys. About 10%-20% the tumors occur elsewhere in the body.
    Adrenal Glands
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    Causes

    The cause is not yet known. Scientists suspect a genetic link.

    Risk Factors

    Factors associated with pheochromocytoma include:

    Symptoms

    Up to 50% of patients have no symptoms. This tumor is found during the investigation of some other unrelated illness.
    Symptoms may occur many times during the day. They can also occur as infrequently as once every few months. Symptoms may be brought on by pressure on the tumor (during a massage), medicines (such as certain anesthetics and beta-blockers), or intense emotion. Symptoms can include:
    • Severe headaches
    • Excessive sweating
    • Fast heart rate ( tachycardia )
    • Sensation of a panic attack
    • Vision changes (blurred vision)
    • Nausea, vomiting, constipation
    • Pounding heart beat (palpitations)
    • Chest pain
    • Involuntary trembling (tremor)
    • Pain in the lower chest or upper abdomen
    • Warmth, flushing
    • Increased appetite
    • Weight loss
    • Insomnia
    • High blood pressure (either sporadic or constant)
    • Tingling, burning, or numbness in the legs and feet
    • Shortness of breath
    • Muscle weakness
    • Anxiety
    • Unable to cope with high temperature
    • Aggressive or unusual behavior

    Diagnosis

    Your doctor will take a medical history. A physical exam will be done.
    Your doctor may need to test your bodily fluids. This can be done with:
    • 24-hour urine testing
    • Blood testing
    • Clonidine suppression test
    Your doctor may need images of your body structures. This can be done with:

    Treatment

    Laparoscopic Adrenalectomy

    If the tumor is benign, it is removed. This procedure uses small incisions and special instruments.
    Sometimes, the adrenal glands are removed as a part of this process.

    Medications

    Prior to surgery, high blood pressure will need to be brought under control using blood pressure lowering medicines.

    Chemotherapy

    This may be used if the tumor is cancerous and has spread outside of the adrenal glands.
    Radiation may also be used to help destroy the tumors if they have spread
    This may be used if the tumor is cancerous and has spread outside of the adrenal glands.
    Radiation may also be used to help destroy the tumors if they have spread

    Prevention

    There are no known prevention methods.

    RESOURCES

    American Cancer Society http://www.cancer.org/

    National Cancer Institute http://www.cancer.gov

    CANADIAN RESOURCES

    HealthLinkBC http://www.healthlinkbc.ca/

    Canadian Cancer Society http://www.cancer.ca/

    References

    Altiner S, Dodell G, Abed J, Blackford L, Colt E. Pheochromocytoma-Induced Aggression? Endocr Pract . 2011;29:1-10.

    Lenders JW, Eisenhofer G, Mannelli M, et al. Phaeochromocytoma. Lancet . 2005;366(9486):665-675.

    Mittendorf EA, Evans DB, Lee JE, et al. Pheochromocytoma: advances in genetics, diagnosis, localization and treatment. Hematol Oncol Clin North Am . 2007;21:509-525.

    Phoechromocytoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 18, 2012. Accessed January 2, 2013.

    Widimsky J Jr. Recent advances in the diagnosis and treatment of pheochromacytoma. Kidney Blood Res . 2006;29:321-326

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