Pheochromocytoma

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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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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 Gao Yi Shen
Neurosurgery
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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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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.

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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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Pheochromocytoma secretes what?

Pheochromocytoma typically refers to tumors that originate from chromaffin tissue of the neural crest, and more often the tumors arise from sympathetic or parasympathetic ganglia, primarily secreting catecholamines. Many patients, due to long-term secretion of catecholamines, experience significant hypertension; severe cases may lead to hypertensive crises and cause serious damage to the heart, brain, and kidneys, or even life-threatening conditions due to severe hypertension. In most cases, if diagnosed and treated early, satisfactory treatment results can often be achieved. Those with pheochromocytoma should visit local hospitals in a timely manner for early diagnosis and treatment.

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Written by Chen Yu Fei
Neurosurgery
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Pheochromocytoma Test Items

For pheochromocytoma, the usual tests include routine blood tests, routine urine tests, and biochemical examinations. Specific tests mainly involve collecting blood and urine catecholamine metabolites to help diagnose the condition. Furthermore, further localization diagnostics are conducted on the patient via abdominal ultrasound, as well as CT or MRI scans, to determine the specific location of the pheochromocytoma growth. Further examinations are conducted in preparation for subsequent surgery, with treatment generally recommended to be surgical. During treatment, antihypertensive drugs are used in conjunction to control blood pressure and maintain stability of the condition.

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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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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.

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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.