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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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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Can a pheochromocytoma be treated without surgery?

For pheochromocytoma, it is still best to receive surgical treatment. Conservative treatment through medication alone has limited effects. In most cases, gradually increasing blood pressure leads to serious symptoms or signs in the patient, such as palpitations, shortness of breath, labored breathing, chest pain, accompanied by profuse sweating, and even severe panic and feelings of impending doom, posing serious life-threatening risks to the patient. In terms of treatment, it is advised to prioritize surgical removal of the tumor, as this can fundamentally lead to a complete cure. Additionally, appropriate medication can be used before and after the surgery to assist in treatment.

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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.

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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.