Pheochromocytoma: Symptoms, Causes, Treatment
ورم القواتم
Pheochromocytoma is a rare adrenal tumor that may release hormones causing hypertension, palpitations and sweating. Endocrine evaluation and specialist preparation are essential before intervention.
What is Pheochromocytoma?
Symptoms may be episodic or involve sustained hypertension, and some tumors are found incidentally. Related tumors outside the adrenal gland are called paragangliomas.
Related reading: Hypertension and assessment of its causes.
Symptoms
Headache, palpitations, sweating, elevated blood pressure, trembling or pallor can occur. These findings are not specific, so recurrent episodes need structured assessment.
Causes
The tumor arises from adrenal medullary cells and may be hereditary or occur without an obvious family history. Anxiety alone should not automatically explain repeated compatible episodes.
Risk factors
Certain hereditary syndromes and family history increase risk. An absent family history does not exclude the tumor or the need to discuss genetic testing.
Diagnosis
Blood or urine metanephrines are tested with appropriate preparation, followed by localization imaging. Genetic evaluation is discussed; an adrenal mass should not undergo unplanned biopsy before hormonal assessment.
Treatment
Suitable surgical cases require medication preparation by endocrine and anesthesia teams. When beta blockade is needed, appropriate alpha blockade comes first; sequencing must not be attempted independently.
Complications
Hypertensive crisis, arrhythmia, cardiac injury or stroke can occur. Recurrence or metastatic disease is possible, requiring individualized long-term follow-up.
Prevention
There is no guaranteed prevention. Follow post-treatment surveillance and recommended genetic counseling, and inform teams before procedures or anesthesia.
When to see a doctor
Chest pain, sudden severe headache, breathlessness or stroke symptoms with hypertension requires emergency care. Do not attempt to control a severe crisis using unplanned extra doses.