How is pheochromocytoma diagnosed?

Written by Chen Yu Fei
Neurosurgery
Updated on September 23, 2024
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For the diagnosis of pheochromocytoma, further examinations need to be completed first. These examinations mainly include qualitative tests and localization tests. The qualitative tests are primarily conducted through laboratory tests to measure the levels of catecholamine-related metabolites to further determine the presence of the tumor. Localization tests are performed using abdominal ultrasound, abdominal CT, and, if necessary, high-resolution abdominal CT to pinpoint the location of the tumor. Once the qualitative and localization diagnostics are performed, it can be confirmed whether a pheochromocytoma exists and its specific location. Depending on the situation, surgery can be used to remove the tumor, in conjunction with pharmacological treatment.

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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.

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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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Can pheochromocytoma be cured?

Currently, with the continuous advancement of surgical techniques, pheochromocytomas can be treated promptly and effectively, achieving favorable outcomes. Once a pheochromocytoma is diagnosed and accurately localized, it is advisable to promptly proceed with surgical intervention. Removing the tumor surgically usually results in effective treatment outcomes. Before surgery, imaging studies and biochemical tests are used for the qualitative and locational diagnosis. After the nature and location of the tumor are clearly identified, the success rate of the surgery can also be increased. Pre-operative use of adrenergic receptor blockers can effectively manage the condition, leading to a reduction in blood pressure and lessening the load on the heart, thereby ensuring smooth conduct of the surgery.

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Written by Chen Yu Fei
Neurosurgery
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What tests are used for pheochromocytoma?

For pheochromocytoma, it is usual to perform both qualitative and localization diagnoses. The qualitative diagnosis is generally based on the measurement of catecholamines and their metabolites in the patient's blood and urine. Localization diagnosis is more commonly determined through methods such as CT scans, MRI, and ultrasound to pinpoint the specific location of the pheochromocytoma, facilitating surgical treatment. Most patients achieve satisfactory results from surgery. Additionally, treatment may include the use of antihypertensive drugs. With combined treatment, most patients can achieve satisfactory results. It is recommended to seek treatment at a well-known tertiary hospital locally.

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Written by Chen Yu Fei
Neurosurgery
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Pheochromocytoma blood pressure how much

For patients with pheochromocytoma, they often present with a hypermetabolic state, elevated blood pressure, even reaching above 200 mmHg, along with significant hypertension and hyperglycemia. Patients may experience headaches, dizziness, nausea, vomiting, profuse sweating, and even chest pain and labored breathing. When such symptoms occur, it is important to promptly take the patient to a local hospital for medical attention. Appropriate tests should be conducted to help confirm the diagnosis and determine the specific location of the pheochromocytoma. Treatment typically involves surgical intervention, but it is essential to manage blood pressure with appropriate antihypertensive drugs before, during, and after treatment.