Is it okay not to remove a pheochromocytoma?

Written by Gan Jun
Endocrinology
Updated on February 23, 2025
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For patients diagnosed with pheochromocytoma, it is recommended that surgical removal is the best option. Pheochromocytoma, also known as an adrenal medullary tumor, originates from the sympathetic ganglia in the adrenal medulla and other related chromaffin tissues. This type of disease can secrete large amounts of catecholamines, causing episodic or persistent hypertension, as well as other related metabolic disorder syndromes. It often presents as potentially fatal hypertension, accompanied by potentially fatal hypotension or even shock, leading to symptoms such as increased heart rate, palpitations, and fear. Patients with pheochromocytoma are advised to undergo timely surgical treatment, as general drug treatments are unable to control or cure the condition.

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Can pheochromocytoma metastasize?

Pheochromocytoma is a special type of tumor originating from chromaffin cells of the adrenal gland. Most of these tumors are benign, with only a minority of patients experiencing malignancy. Clinically, the likelihood of tumor malignancy is about 10%. Most patients have a good prognosis after surgical removal, and if the tumor shows distant metastasis, it can be determined that the disease has become malignant. Due to the unique origin of pheochromocytomas in the adrenal medulla chromaffin cells, the tumor tissue continuously grows in the body and synthesizes and metabolizes catecholamines such as adrenaline, dopamine, and noradrenaline. Clinically, nearly 90% of patients do not develop cancer throughout their lives, therefore most pheochromocytomas are benign. However, about 10% of patients experience distant metastases, and once metastasized, it is considered a malignant tumor.

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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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Can a pheochromocytoma be treated without surgery?

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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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.

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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.