PheochromocytomaPheochromocytoma is a neoplasms that is found in the Adrenal Medulla. This tumor affects the nervous system by secreting Catecholamines or hormones that act as a neurotransmitter. Catecholamines are hormones such as: Noreponephine and Epinephrine.

It is also referred to as a Neuroendocrine tumor because of its location.

Typically this is a benign tumor and 10% are located on both sides of the Adrenal Medulla.  That means that 805+ are located on one side or the other and are considered as unilateral location. About 10% are found in the Medulla and outside the area.

Malignancy is rare in both children and adults. Diagnosis of malignancy vs benign is typically done with surgery.

Rule of 10’s in Distribution

–  10% are malignant
–  10% are seen in childhood
–  10% can reoccur after surgery

Symptoms of those diagnosed with this tumor can exhibit:

–  Hypertension (Elevated Blood Pressure)
–  Elevated Heart rate
–  Heart Palpatations
–  Sweating (Excessive)
–  Weightloss
–  Headaches
–  Nausea
–  Anxiety
–  Panic Attacks

Causes of Pheochromocytoma

1.)  Genetics – 25% of tumors are familial related.

2.)  Gene Mutation

Diagnosis

–  Symptoms and History
–  Physical Exam
–  Labs: Vanillylmandelic Acid and Meterphrines

Treatment:

–  Surgery to resect the tumor.
–  Surgery can be done laproscopy or by open laparotomy.
–  The Surgery needs to be done by a specialist due to the complexity of the surgery.

Medications

–  Medications are often take prior and post surgery

.     Phenoxybenzamine is typically first options

Other options include:

1.)  Prazosin
2.)  Terazosin
3.)  Doxazosin
4.)  Labetolol

*** Propanolol can never be used

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