How is pheochromocytoma treated?

Written by Chen Yu Fei
Neurosurgery
Updated on August 31, 2024
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Currently, for the treatment of pheochromocytoma, it is primarily important that once diagnosed with pheochromocytoma, one should promptly visit the local hospital to arrange surgical treatment as soon as possible. By surgically removing the pheochromocytoma, this prevents the excessive secretion of catecholamines, which can lead to a hypertensive crisis in patients. Therefore, clinically, after diagnosing and locating the pheochromocytoma, receiving surgical treatment can often achieve satisfactory therapeutic outcomes. Typically, appropriate preparations must be made before surgery. Generally, prior to the operation, it is crucial to actively administer medications such as alpha-adrenergic blockers, beta-adrenergic blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, vasodilators, and catecholamine synthesis inhibitors to effectively treat and stabilize blood pressure.

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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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Malignant manifestations of pheochromocytoma

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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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 Hao Li Bin
Neurosurgery
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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.

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Endocrinology
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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.