Malignant manifestations of pheochromocytoma

Written by Chen Yu Fei
Neurosurgery
Updated on September 06, 2024
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For patients with pheochromocytoma, when malignant pheochromocytoma occurs and leads to hypertensive crisis, it often causes severe blood pressure increases, with blood pressure even reaching over 300 mmHg. At the same time, patients present with significant symptoms such as arrhythmia, tachycardia, palpitations, and shortness of breath. Some patients may also experience prominent chest pain, labored breathing, respiratory distress, and even marked sensations of urgency or anxiety, as well as a feeling of impending doom. Additionally, some patients may experience transient vascular constriction dysfunction due to severe hypertension, leading to cerebral hemorrhage.

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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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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.

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Neurosurgery
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The manifestations of pheochromocytoma crisis

For patients with pheochromocytoma, during a crisis, it generally manifests as a sudden increase in the patient's blood pressure, which can rise to above 200-300 mmHg. Additionally, the patient experiences severe headaches and dizziness, severe nausea and vomiting. Some patients may experience significant discomfort and tachycardia, arrhythmias. Some patients also suffer from abdominal or chest pain, labored breathing, and difficulty breathing, and even blurred vision. In severe cases, the excessively high blood pressure can lead to hypertensive cerebral hemorrhage or other unexpected cardiovascular and cerebrovascular diseases. The patient’s vital signs are extremely unstable, often accompanied by multiple organ dysfunction or failure.

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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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Pheochromocytoma Test Items

For pheochromocytoma, the usual tests include routine blood tests, routine urine tests, and biochemical examinations. Specific tests mainly involve collecting blood and urine catecholamine metabolites to help diagnose the condition. Furthermore, further localization diagnostics are conducted on the patient via abdominal ultrasound, as well as CT or MRI scans, to determine the specific location of the pheochromocytoma growth. Further examinations are conducted in preparation for subsequent surgery, with treatment generally recommended to be surgical. During treatment, antihypertensive drugs are used in conjunction to control blood pressure and maintain stability of the condition.