Management of Pheochromocytoma Crisis

Written by Chen Yu Fei
Neurosurgery
Updated on April 21, 2025
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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 Chen Yu Fei
Neurosurgery
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Which department should I go to for pheochromocytoma?

When pheochromocytoma occurs, it is generally recommended to visit the endocrinology department of a local hospital. Pheochromocytoma refers to tumors originating from the neuroectoderm, specifically chromaffin tissue. These tumors usually secrete catecholamines and can be classified into various types based on their origin. Patients typically exhibit a pronounced hypermetabolic state, such as malignant hypertension or hyperglycemia, and some suffer significant damage to the heart, kidneys, liver, and brain tissue due to malignant hypertension. For instance, this can lead to heart failure or hypertensive cerebral hemorrhage, severely threatening the patient's life. Treatment typically involves surgical intervention.

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Written by Li Lang Bo
Endocrinology
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What should I do if pheochromocytoma causes excessive sweating?

Patients with pheochromocytoma generally exhibit profuse sweating, which is a manifestation of sympathetic excitement. This occurs because the capillary beds throughout the body of a person with pheochromocytoma are constricted, including the sweat glands. Thus, it is easy to exhibit these symptoms of sympathetic excitement, characterized by nervousness, heavy sweating, and weight loss. So, how should this be treated? The key is to treat the cause. In the clinic, after collecting some blood history, conducting various blood tests, and performing adrenal CT scans among other imaging studies, a clear diagnosis of pheochromocytoma is made. Then, we will use some alpha receptor blockers, one to lower the blood pressure to a normal range and another to dilate the capillary beds throughout the body. After this, we proceed with the related surgical treatment. Following the surgical removal of the tumor, symptoms such as sweating will gradually be relieved.

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Written by Chen Yu Fei
Neurosurgery
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Is pheochromocytoma a cancer?

Pheochromocytoma is not a cancer. It is a special type of tumor tissue that usually originates from the neuroectodermal chromaffin tissue. It can secrete catecholamines. Based on the specific origins of the tumor cells, it can be divided into types such as parasympathetic, paraganglioma, sympathetic, and ganglioneuroma. Most often, it presents with long-term hypertension, which can cause damage to the heart, brain, and kidneys due to prolonged hypertension, or severe increases in blood pressure can lead to hypertensive brain hemorrhage, thereby endangering the patient's life. Early treatment is often necessary.

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Written by Chen Yu Fei
Neurosurgery
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How is pheochromocytoma diagnosed?

For the examination of pheochromocytoma, it is generally recommended to use qualitative or localization diagnostic methods. Qualitative examinations typically involve collecting metabolites of catecholamines from urine and blood to further facilitate a definitive diagnosis. Localization examinations are conducted through abdominal ultrasound, CT, or MRI to further identify the specific growth location of the pheochromocytoma. After a definitive diagnosis through qualitative and localization examinations, surgery is generally recommended to effectively remove the pheochromocytoma. Additionally, antihypertensive medication can be used to help control symptoms.

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Written by Chen Yu Fei
Neurosurgery
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What department should I go to for pheochromocytoma?

Pheochromocytoma generally requires consultation at the endocrinology or surgical department. Please ask a physician to assess the current situation. For further examination and diagnosis of pheochromocytoma, qualitative and locational diagnostics are necessary. Qualitative diagnostics typically involve blood tests where levels of catecholamine metabolites in the blood and urine are tested to assist in diagnosis; locational diagnostics involve using CT scans, MRI, and ultrasound to help determine the specific location of the tumor. Treatment for pheochromocytoma generally involves surgical removal of the tumor once it is found, combined with medication treatment, which often leads to satisfactory therapeutic outcomes.