How is pheochromocytoma diagnosed?

Written by Chen Yu Fei
Neurosurgery
Updated on September 13, 2024
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For patients with pheochromocytoma, comprehensive examinations are necessary for diagnosis. For instance, measuring catecholamines and their metabolites in blood or urine can help determine if there is a noticeable increase in catecholamine levels. Furthermore, adrenal CT scans can be used to assess the condition, where in many cases, significant occupying lesions can be detected through adrenal CT scans. In addition, other related tests also hold diagnostic value and significance, such as magnetic resonance imaging, ultrasound, and related nuclear scanning tests, which can assist in qualitative and locational diagnosis.

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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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Neurosurgery
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The manifestations of pheochromocytoma crisis

For patients with pheochromocytoma, during a crisis, it generally manifests as a sudden increase in the patient's blood pressure, which can rise to above 200-300 mmHg. Additionally, the patient experiences severe headaches and dizziness, severe nausea and vomiting. Some patients may experience significant discomfort and tachycardia, arrhythmias. Some patients also suffer from abdominal or chest pain, labored breathing, and difficulty breathing, and even blurred vision. In severe cases, the excessively high blood pressure can lead to hypertensive cerebral hemorrhage or other unexpected cardiovascular and cerebrovascular diseases. The patient’s vital signs are extremely unstable, often accompanied by multiple organ dysfunction or failure.

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Neurosurgery
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How is pheochromocytoma treated?

Currently, for the treatment of pheochromocytoma, it is primarily important that once diagnosed with pheochromocytoma, one should promptly visit the local hospital to arrange surgical treatment as soon as possible. By surgically removing the pheochromocytoma, this prevents the excessive secretion of catecholamines, which can lead to a hypertensive crisis in patients. Therefore, clinically, after diagnosing and locating the pheochromocytoma, receiving surgical treatment can often achieve satisfactory therapeutic outcomes. Typically, appropriate preparations must be made before surgery. Generally, prior to the operation, it is crucial to actively administer medications such as alpha-adrenergic blockers, beta-adrenergic blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, vasodilators, and catecholamine synthesis inhibitors to effectively treat and stabilize blood pressure.

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What should I do if a pheochromocytoma ruptures?

When a pheochromocytoma ruptures, it is advised that the patient immediately goes to the emergency department of the hospital for relevant examinations to confirm the diagnosis and to immediately control the blood pressure to a relatively stable and safe level. After a comprehensive evaluation, the urology department will perform emergency surgical removal to save the patient's life. Spontaneous rupture and bleeding of adrenal pheochromocytoma is quite rare. The possible reasons might be long-term hypertension leading to poor vascular function, or rapid tumor growth with high capsule pressure causing vascular rupture. Additionally, intense exercise, excessive fatigue, and transient increases in blood pressure could also be triggering factors.

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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.