Can malignant pheochromocytoma be cured?

Written by Gan Jun
Endocrinology
Updated on January 07, 2025
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When pheochromocytoma becomes malignant, it can be cured through clinical approaches, although malignant pheochromocytoma mainly refers to those that have distant metastases. It primarily exhibits aggressive growth or is accompanied by metastases to other organs, and surgery cannot completely remove it, leading to a high recurrence rate post-surgery. Generally, the five-year survival rate for patients with malignant pheochromocytoma does not exceed half.

If treated with chemotherapy or arterial embolization, it can control the patient's blood pressure and alleviate the tumor burden, thereby extending the survival period.

In summary, the treatment of malignant pheochromocytoma is relatively challenging, has a high recurrence rate, and poses a significant threat to human life.

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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 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 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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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 Chen Yu Fei
Neurosurgery
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How is pheochromocytoma diagnosed?

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.