How to test for pheochromocytoma?

Written by Li Pei
Neurosurgery
Updated on September 13, 2024
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Pheochromocytoma is a tumor that occurs in the adrenal gland. The tumor secretes a large amount of catecholamines, causing an increase in blood pressure. Diagnostic tests for pheochromocytoma can include a CT scan and MRI of the adrenal glands to confirm the presence of any adrenal mass. Additionally, ultrasound can also be used as an auxiliary test to help confirm the diagnosis. It is also advisable to check the levels of catecholamines in the blood and urine to further confirm the presence of an adrenal pheochromocytoma.

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Written by Chen Yu Fei
Neurosurgery
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Malignant symptoms of pheochromocytoma

For pheochromocytoma, if not treated adequately, it often leads to severe hypertensive crises in patients, characterized by extreme spikes in blood pressure accompanied by profuse sweating, palpitations, shortness of breath, chest pain, and numbness in the limbs. Excessively high blood pressure can easily trigger pathological changes in the heart, kidneys, liver, and brain tissues, possibly leading to hypertensive brain hemorrhage, and even endangering the patient's life. Therefore, if pheochromocytoma is not managed and treated properly, it often results in critical illness and might even endanger the patient's life. It is recommended that once diagnosed, hospitalization should be sought promptly, and surgical treatment should be considered if necessary.

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Written by Li Lang Bo
Endocrinology
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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.

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Written by Chen Yu Fei
Neurosurgery
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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.)

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Written by Chen Yu Fei
Neurosurgery
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How is pheochromocytoma diagnosed?

For the examination of pheochromocytoma, it is generally recommended to use qualitative or localization diagnostic methods. Qualitative examinations typically involve collecting metabolites of catecholamines from urine and blood to further facilitate a definitive diagnosis. Localization examinations are conducted through abdominal ultrasound, CT, or MRI to further identify the specific growth location of the pheochromocytoma. After a definitive diagnosis through qualitative and localization examinations, surgery is generally recommended to effectively remove the pheochromocytoma. Additionally, antihypertensive medication can be used to help control symptoms.

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Endocrinology
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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.