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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

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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