The manifestations of pheochromocytoma crisis

Written by Chen Yu Fei
Neurosurgery
Updated on September 11, 2024
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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 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 treated?

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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Endocrinology
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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.

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Neurosurgery
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Can a pheochromocytoma be treated without surgery?

For pheochromocytoma, it is still best to receive surgical treatment. Conservative treatment through medication alone has limited effects. In most cases, gradually increasing blood pressure leads to serious symptoms or signs in the patient, such as palpitations, shortness of breath, labored breathing, chest pain, accompanied by profuse sweating, and even severe panic and feelings of impending doom, posing serious life-threatening risks to the patient. In terms of treatment, it is advised to prioritize surgical removal of the tumor, as this can fundamentally lead to a complete cure. Additionally, appropriate medication can be used before and after the surgery to assist in treatment.

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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.