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Pheochromocytoma
Can pheochromocytoma metastasize?
Pheochromocytoma is a special type of tumor originating from chromaffin cells of the adrenal gland. Most of these tumors are benign, with only a minority of patients experiencing malignancy. Clinically, the likelihood of tumor malignancy is about 10%. Most patients have a good prognosis after surgical removal, and if the tumor shows distant metastasis, it can be determined that the disease has become malignant. Due to the unique origin of pheochromocytomas in the adrenal medulla chromaffin cells, the tumor tissue continuously grows in the body and synthesizes and metabolizes catecholamines such as adrenaline, dopamine, and noradrenaline. Clinically, nearly 90% of patients do not develop cancer throughout their lives, therefore most pheochromocytomas are benign. However, about 10% of patients experience distant metastases, and once metastasized, it is considered a malignant tumor.
Management of Pheochromocytoma Crisis
When a pheochromocytoma crisis occurs, the patient often first shows significant elevations in blood pressure, usually characterized by a rise in systolic pressure, which can exceed 200mmHg or even 300mmHg. Immediate administration of antihypertensive drugs for symptomatic treatment is necessary. Additionally, the patient may exhibit a clear hypermetabolic state, with profuse sweating, limb convulsions, and even consciousness disorders. At this point, the patient should be immediately transferred to the intensive care unit for close observation of any changes in their condition, and effective monitoring of vital signs should be conducted. Furthermore, patients should receive cardiac monitoring, blood oxygen saturation monitoring, and can be given intravenous infusions of sodium nitroprusside to rapidly reduce blood pressure. Meanwhile, ongoing observation of the patient’s condition and appropriate replenishment of blood volume are needed. (Please administer medication under the guidance of a professional physician and do not medicate blindly.)
Which department should I go to for pheochromocytoma?
When pheochromocytoma occurs, it is generally recommended to visit the endocrinology department of a local hospital. Pheochromocytoma refers to tumors originating from the neuroectoderm, specifically chromaffin tissue. These tumors usually secrete catecholamines and can be classified into various types based on their origin. Patients typically exhibit a pronounced hypermetabolic state, such as malignant hypertension or hyperglycemia, and some suffer significant damage to the heart, kidneys, liver, and brain tissue due to malignant hypertension. For instance, this can lead to heart failure or hypertensive cerebral hemorrhage, severely threatening the patient's life. Treatment typically involves surgical intervention.
Pheochromocytoma blood pressure how much
For patients with pheochromocytoma, they often present with a hypermetabolic state, elevated blood pressure, even reaching above 200 mmHg, along with significant hypertension and hyperglycemia. Patients may experience headaches, dizziness, nausea, vomiting, profuse sweating, and even chest pain and labored breathing. When such symptoms occur, it is important to promptly take the patient to a local hospital for medical attention. Appropriate tests should be conducted to help confirm the diagnosis and determine the specific location of the pheochromocytoma. Treatment typically involves surgical intervention, but it is essential to manage blood pressure with appropriate antihypertensive drugs before, during, and after treatment.
What tests are used for pheochromocytoma?
For pheochromocytoma, it is usual to perform both qualitative and localization diagnoses. The qualitative diagnosis is generally based on the measurement of catecholamines and their metabolites in the patient's blood and urine. Localization diagnosis is more commonly determined through methods such as CT scans, MRI, and ultrasound to pinpoint the specific location of the pheochromocytoma, facilitating surgical treatment. Most patients achieve satisfactory results from surgery. Additionally, treatment may include the use of antihypertensive drugs. With combined treatment, most patients can achieve satisfactory results. It is recommended to seek treatment at a well-known tertiary hospital locally.
Is it okay not to remove a pheochromocytoma?
For patients diagnosed with pheochromocytoma, it is recommended that surgical removal is the best option. Pheochromocytoma, also known as an adrenal medullary tumor, originates from the sympathetic ganglia in the adrenal medulla and other related chromaffin tissues. This type of disease can secrete large amounts of catecholamines, causing episodic or persistent hypertension, as well as other related metabolic disorder syndromes. It often presents as potentially fatal hypertension, accompanied by potentially fatal hypotension or even shock, leading to symptoms such as increased heart rate, palpitations, and fear. Patients with pheochromocytoma are advised to undergo timely surgical treatment, as general drug treatments are unable to control or cure the condition.
What should I do if a pheochromocytoma ruptures?
When a pheochromocytoma ruptures, it is advised that the patient immediately goes to the emergency department of the hospital for relevant examinations to confirm the diagnosis and to immediately control the blood pressure to a relatively stable and safe level. After a comprehensive evaluation, the urology department will perform emergency surgical removal to save the patient's life. Spontaneous rupture and bleeding of adrenal pheochromocytoma is quite rare. The possible reasons might be long-term hypertension leading to poor vascular function, or rapid tumor growth with high capsule pressure causing vascular rupture. Additionally, intense exercise, excessive fatigue, and transient increases in blood pressure could also be triggering factors.
What should I do if pheochromocytoma causes excessive sweating?
Patients with pheochromocytoma generally exhibit profuse sweating, which is a manifestation of sympathetic excitement. This occurs because the capillary beds throughout the body of a person with pheochromocytoma are constricted, including the sweat glands. Thus, it is easy to exhibit these symptoms of sympathetic excitement, characterized by nervousness, heavy sweating, and weight loss. So, how should this be treated? The key is to treat the cause. In the clinic, after collecting some blood history, conducting various blood tests, and performing adrenal CT scans among other imaging studies, a clear diagnosis of pheochromocytoma is made. Then, we will use some alpha receptor blockers, one to lower the blood pressure to a normal range and another to dilate the capillary beds throughout the body. After this, we proceed with the related surgical treatment. Following the surgical removal of the tumor, symptoms such as sweating will gradually be relieved.
Can malignant pheochromocytoma be cured?
When pheochromocytoma becomes malignant, it can be cured through clinical approaches, although malignant pheochromocytoma mainly refers to those that have distant metastases. It primarily exhibits aggressive growth or is accompanied by metastases to other organs, and surgery cannot completely remove it, leading to a high recurrence rate post-surgery. Generally, the five-year survival rate for patients with malignant pheochromocytoma does not exceed half. If treated with chemotherapy or arterial embolization, it can control the patient's blood pressure and alleviate the tumor burden, thereby extending the survival period. In summary, the treatment of malignant pheochromocytoma is relatively challenging, has a high recurrence rate, and poses a significant threat to human life.
What size of pheochromocytoma is malignant?
The size of pheochromocytomas and the benign or malignant nature of the tumor are not greatly related. Usually, most are familial pheochromocytomas, which are most commonly bilateral, but they have a relatively high recurrence rate and are difficult to treat with fewer available treatment options. Once a pheochromocytoma is detected, it should be taken seriously and treated promptly. The presence of a tumor often indicates that it has developed to the mid and late stages, where it becomes relatively difficult to cure. Regardless of whether the tumor is large or small, it must be taken seriously and treated with care, otherwise, it may easily worsen and affect health.