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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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 Li Pei
Neurosurgery
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How to test for pheochromocytoma?

Pheochromocytoma is a tumor that occurs in the adrenal gland. The tumor secretes a large amount of catecholamines, causing an increase in blood pressure. Diagnostic tests for pheochromocytoma can include a CT scan and MRI of the adrenal glands to confirm the presence of any adrenal mass. Additionally, ultrasound can also be used as an auxiliary test to help confirm the diagnosis. It is also advisable to check the levels of catecholamines in the blood and urine to further confirm the presence of an adrenal pheochromocytoma.

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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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Written by Gan Jun
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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Written by Chen Yu Fei
Neurosurgery
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Malignant symptoms of pheochromocytoma

For pheochromocytoma, if not treated adequately, it often leads to severe hypertensive crises in patients, characterized by extreme spikes in blood pressure accompanied by profuse sweating, palpitations, shortness of breath, chest pain, and numbness in the limbs. Excessively high blood pressure can easily trigger pathological changes in the heart, kidneys, liver, and brain tissues, possibly leading to hypertensive brain hemorrhage, and even endangering the patient's life. Therefore, if pheochromocytoma is not managed and treated properly, it often results in critical illness and might even endanger the patient's life. It is recommended that once diagnosed, hospitalization should be sought promptly, and surgical treatment should be considered if necessary.