Is surgery necessary for pheochromocytoma?

Written by Chen Yu Fei
Neurosurgery
Updated on September 13, 2024
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For patients diagnosed with pheochromocytoma, it is recommended to undergo surgery as soon as possible. Complete surgical removal of the tumor often results in a very good therapeutic effect. Before surgery, some medications can be appropriately used for treatment. For example, it is advised to choose adrenergic receptor blockers, which can significantly improve the patient's condition. These can be taken orally before the operation to help gradually regulate blood pressure, or other medications such as calcium channel blockers, angiotensin-converting enzyme inhibitors, and vasodilators may be used. Only through a combination of medication and surgery can satisfactory treatment results be achieved.

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Written by Gao Yi Shen
Neurosurgery
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What department does pheochromocytoma see?

Pheochromocytomas generally require a visit to urology for treatment. Initially, they mostly present with symptoms of hypertension, leading many to first visit cardiology. After differential diagnoses have ruled out other causes and confirmed pheochromocytoma, patients must then seek treatment from urology. Pheochromocytomas are generally located in the adrenal glands, hence they require surgical removal by a urologist. It is crucial to strictly control blood pressure during surgery, as fluctuations can be severe and significantly impact the patient's physical and mental health. Therefore, if a pheochromocytoma is detected, it is critical to seek timely medical treatment for a relatively better prognosis.

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Written by Chen Yu Fei
Neurosurgery
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Pheochromocytoma clinical manifestations

Pheochromocytoma typically presents with severe hypertension, with blood pressure even reaching above 200/140 mmHg, accompanied by significant discomfort, such as profuse sweating, chest pain, obvious difficulty in breathing, chest tightness, shortness of breath, and other clinical manifestations. Moreover, if not treated timely and effectively, it can even lead to a hypertensive crisis. It also poses a severe threat to the patient’s heart, kidneys, liver, and brain tissues. Some patients might develop cerebrovascular diseases due to very high blood pressure, such as hypertensive cerebral hemorrhage, which can threaten the patient's life.

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Written by Chen Yu Fei
Neurosurgery
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Pheochromocytoma typical manifestations

For pheochromocytoma, the term usually refers to tumors arising from the chromaffin tissue of the neural crest. Clinically, the main typical symptoms include severe hypertension, along with nausea, vomiting, intense headache, and dizziness. Additionally, it may also cause the patient to be in a continuous high metabolic state, characterized by persistent hyperglycemia, nausea, vomiting, and excessive sweating. If not treated promptly and effectively, it may pose serious threats to the patient's heart, brain, and kidneys. In severe cases, it could even be life-threatening. Surgery is commonly recommended for treatment.

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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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Written by Chen Yu Fei
Neurosurgery
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Causes of hypotension in pheochromocytoma

For cases of hypotension occurring in pheochromocytoma, it is most commonly seen after the surgical removal of the tumor. At this point, the concentration of catecholamines in the blood may significantly decrease, leading to a marked reduction in effective circulating blood volume, and thus causing hypotension. This situation is relatively common after surgery for pheochromocytoma. Usually, after surgical treatment and removal of the tumor, it is important to promptly discontinue the use of receptor blockers in patients and to appropriately replenish blood volume to effectively maintain central venous pressure. This approach can generally counteract the reduction in catecholamine levels caused by surgery, which leads to hypotension.