Pheochromocytoma clinical manifestations

Written by Chen Yu Fei
Neurosurgery
Updated on September 19, 2024
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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 should I do if pheochromocytoma causes excessive sweating?

Patients with pheochromocytoma generally exhibit profuse sweating, which is a manifestation of sympathetic excitement. This occurs because the capillary beds throughout the body of a person with pheochromocytoma are constricted, including the sweat glands. Thus, it is easy to exhibit these symptoms of sympathetic excitement, characterized by nervousness, heavy sweating, and weight loss. So, how should this be treated? The key is to treat the cause. In the clinic, after collecting some blood history, conducting various blood tests, and performing adrenal CT scans among other imaging studies, a clear diagnosis of pheochromocytoma is made. Then, we will use some alpha receptor blockers, one to lower the blood pressure to a normal range and another to dilate the capillary beds throughout the body. After this, we proceed with the related surgical treatment. Following the surgical removal of the tumor, symptoms such as sweating will gradually be relieved.

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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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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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Can malignant pheochromocytoma be cured?

When pheochromocytoma becomes malignant, it can be cured through clinical approaches, although malignant pheochromocytoma mainly refers to those that have distant metastases. It primarily exhibits aggressive growth or is accompanied by metastases to other organs, and surgery cannot completely remove it, leading to a high recurrence rate post-surgery. Generally, the five-year survival rate for patients with malignant pheochromocytoma does not exceed half. If treated with chemotherapy or arterial embolization, it can control the patient's blood pressure and alleviate the tumor burden, thereby extending the survival period. In summary, the treatment of malignant pheochromocytoma is relatively challenging, has a high recurrence rate, and poses a significant threat to human life.

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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.