The manifestations of pheochromocytoma crisis

Written by Chen Yu Fei
Neurosurgery
Updated on September 11, 2024
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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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How to test for pheochromocytoma?

Pheochromocytoma is a tumor that occurs in the adrenal gland. The tumor secretes a large amount of catecholamines, causing an increase in blood pressure. Diagnostic tests for pheochromocytoma can include a CT scan and MRI of the adrenal glands to confirm the presence of any adrenal mass. Additionally, ultrasound can also be used as an auxiliary test to help confirm the diagnosis. It is also advisable to check the levels of catecholamines in the blood and urine to further confirm the presence of an adrenal pheochromocytoma.

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Can pheochromocytoma be cured?

Currently, with the continuous advancement of surgical techniques, pheochromocytomas can be treated promptly and effectively, achieving favorable outcomes. Once a pheochromocytoma is diagnosed and accurately localized, it is advisable to promptly proceed with surgical intervention. Removing the tumor surgically usually results in effective treatment outcomes. Before surgery, imaging studies and biochemical tests are used for the qualitative and locational diagnosis. After the nature and location of the tumor are clearly identified, the success rate of the surgery can also be increased. Pre-operative use of adrenergic receptor blockers can effectively manage the condition, leading to a reduction in blood pressure and lessening the load on the heart, thereby ensuring smooth conduct of the surgery.

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Written by Gao Yi Shen
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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
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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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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.