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 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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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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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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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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Written by Chen Yu Fei
Neurosurgery
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Is surgery necessary for pheochromocytoma?

For patients diagnosed with pheochromocytoma, it is recommended to undergo surgery as soon as possible. Complete surgical removal of the tumor often results in a very good therapeutic effect. Before surgery, some medications can be appropriately used for treatment. For example, it is advised to choose adrenergic receptor blockers, which can significantly improve the patient's condition. These can be taken orally before the operation to help gradually regulate blood pressure, or other medications such as calcium channel blockers, angiotensin-converting enzyme inhibitors, and vasodilators may be used. Only through a combination of medication and surgery can satisfactory treatment results be achieved.