Can a pheochromocytoma be treated without surgery?

Written by Chen Yu Fei
Neurosurgery
Updated on September 03, 2024
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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 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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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 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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Is surgery necessary for pheochromocytoma?

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 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.)