Pheochromocytomas are neural crest-derived tumors that produce catecholamines (such as epinephrine and norepinephrine) and arise mainly from the adrenal gland. Closely affiliated tumors of extra-adrenal paraganglia are also known as extra-adrenal pheochromocytomas. All these functional chromaffin tumors can result in substantial morbidity and mortality due to catecholamine oversecretion.
Pheochromocytoma can have exceptionally variable clinical presentations - from rare and escalating hypercatecholaminergic incidents, through rather stable hypertension, to dire and clinically malignant illness that can be complicated by hypertensive crisis, acute myocardial infarction, stroke, and a myriad of other emergent conditions.
Causes of pheochromocytoma …show more content…
Attacks (or spells) may occur several times a day, weekly, or very infrequently (e.g. once every few months), while the episodes may last from just a few seconds to one or more hours (or even longer in patients with chronically elevated catecholamines).
High blood pressure or hypertension is the most common sign and a cardinal feature of pheochromocytoma, which may be sustained or paroxysmal. Hypertensive crisis, stroke or shock sometimes also occur in patients with inadequately controlled disease. Pheochromocytoma may also present with low blood pressure, most often as orthostatic hypotension or as fluctuating episodes of high and low blood pressure.
Headache is seen in up to 90% of patients with pheochromocytoma, which can be similar to tension headache in presentation. Excessive and (most commonly) truncal sweating affects approximately 60-70% patients, while pallor is seen in about 27% of patients. Flushing is much less commonly …show more content…
A tachycardia during a blood pressure surge should also point towards this diagnosis.
Other common symptoms are severe anxiety, fatigue, weakness, tremulousness, nausea, dyspnea, weight loss despite normal appetite (which is a result of catecholamine-induced breakdown of sugar and fat storages), visual issues during an attack and overwhelming tiredness following an attack.
Such attacks can be triggered by palpitation of the tumor, exertion, postural changes, trauma, anxiety, pain, foods or drinks containing tyramine (such as certain cheeses and beers), the use of certain drugs (tyramine, histamine, metoclopramide, phenothiazine), chemotherapy, induction of anesthesia, endoscopy, catheterization, as well as micturition or bladder distention.
Such kaleidoscopic symptomatology in patients with pheochromocytoma reflects variations in nature and types of secreted catecholamines, but co-secretion of neuropeptides (corticothropin, vasoactive intestinal peptide, neuropeptide Y, growth hormone-releasing factor, parathyroid hormone-related peptide, somatostatin and adrenomedulin) must also be
Pheochromocytoma can have exceptionally variable clinical presentations - from rare and escalating hypercatecholaminergic incidents, through rather stable hypertension, to dire and clinically malignant illness that can be complicated by hypertensive crisis, acute myocardial infarction, stroke, and a myriad of other emergent conditions.
Causes of pheochromocytoma …show more content…
Attacks (or spells) may occur several times a day, weekly, or very infrequently (e.g. once every few months), while the episodes may last from just a few seconds to one or more hours (or even longer in patients with chronically elevated catecholamines).
High blood pressure or hypertension is the most common sign and a cardinal feature of pheochromocytoma, which may be sustained or paroxysmal. Hypertensive crisis, stroke or shock sometimes also occur in patients with inadequately controlled disease. Pheochromocytoma may also present with low blood pressure, most often as orthostatic hypotension or as fluctuating episodes of high and low blood pressure.
Headache is seen in up to 90% of patients with pheochromocytoma, which can be similar to tension headache in presentation. Excessive and (most commonly) truncal sweating affects approximately 60-70% patients, while pallor is seen in about 27% of patients. Flushing is much less commonly …show more content…
A tachycardia during a blood pressure surge should also point towards this diagnosis.
Other common symptoms are severe anxiety, fatigue, weakness, tremulousness, nausea, dyspnea, weight loss despite normal appetite (which is a result of catecholamine-induced breakdown of sugar and fat storages), visual issues during an attack and overwhelming tiredness following an attack.
Such attacks can be triggered by palpitation of the tumor, exertion, postural changes, trauma, anxiety, pain, foods or drinks containing tyramine (such as certain cheeses and beers), the use of certain drugs (tyramine, histamine, metoclopramide, phenothiazine), chemotherapy, induction of anesthesia, endoscopy, catheterization, as well as micturition or bladder distention.
Such kaleidoscopic symptomatology in patients with pheochromocytoma reflects variations in nature and types of secreted catecholamines, but co-secretion of neuropeptides (corticothropin, vasoactive intestinal peptide, neuropeptide Y, growth hormone-releasing factor, parathyroid hormone-related peptide, somatostatin and adrenomedulin) must also be