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Pheochromocytoma

(Pheo; Adrenal Gland Tumor; Pheochromocytosis)

Definition

Pheochromocytoma is a tumor that grows on the adrenal glands, which are located on top of the kidneys. It is made up of special adrenal gland cells. The cells secrete hormones such as epinephrine and norepinephrine. These hormones help to regulate the heart rate and blood pressure. The cells may secrete excessive amounts of the hormones. This results in periods of:
90% of these tumors are benign. These tumors occur elsewhere in the body and are called paragangliomas.
Adrenal Glands
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Causes

In most cases, pheochromocytoma has no known cause. In others, it is caused by a genetic mutation.

Risk Factors

Factors that may increase your chance of pheochromocytoma include:
  • A family history
  • Tumors in other glands of the body
  • Hormonal disorders
Genetic diseases associated with pheochromocytoma include:

Symptoms

Many people don't have symptoms. In people who have them, pheochromocytoma may cause:
  • High blood pressure, which can be constant or sporadic
  • Severe headaches
  • Excessive sweating
  • Warmth, flushing
  • Fast heart rate and pounding heart beat
  • Sensation of a panic attack
  • Blurred vision
  • Nausea, vomiting, constipation or diarrhea
  • Chest pain
  • Involuntary trembling
  • Pain in the lower chest or upper abdomen
  • Increased appetite
  • Weight loss
  • Excessive thirst and urination
  • Insomnia
  • Tingling, burning, or numbness in the legs and feet
  • Shortness of breath
  • Muscle weakness
  • Anxiety
  • Unable to cope with high temperature

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Your doctor will need to test your body fluids for metanephrines. This can be done with:
  • Urine testing
  • Blood testing
A clonidine suppression test may be done if these tests do not confirm the diagnosis
Your doctor may need images of your bodily structures to look for the tumor and check if it has spread. These can be done with:

Treatment

Laparoscopic Adrenalectomy

The tumor will be removed whether it is cancerous or not. This procedure uses small incisions and special instruments. Sometimes, the adrenal glands are removed as a part of this process.

Medications

Prior to surgery, high blood pressure will need to be brought under control using blood pressure lowering medications.

Chemotherapy and Radiation Therapy

Chemotherapy may be used if the tumor is cancerous and has spread outside of the adrenal glands.
Radiation therapy may also be used to help destroy the tumors if they have spread.
Chemotherapy may be used if the tumor is cancerous and has spread outside of the adrenal glands.
Radiation therapy may also be used to help destroy the tumors if they have spread.

Prevention

There are no current guidelines to prevent pheochromocytoma.

RESOURCES

American Cancer Society
http://www.cancer.org
National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES

Canadian Cancer Society
http://www.cancer.ca
Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References

Pheochromocytoma. National Organization of Rare Disorders website. Available at: https://rarediseases.org/rare-diseases/pheochromocytoma/. Published 2008. Accessed August 24, 2017.
Pheochromocytoma (adrenaline-producing adrenal tumor). The American Association of Endocrine Surgeons website. Available at: http://endocrinediseases.org/adrenal/pheochromocytoma.shtml. Accessed August 24, 2017.
Pheochromocytoma and paraganglioma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114874/Pheochromocytoma-and-paraganglioma. Updated September 6, 2016. Accessed August 24, 2017.
Pheochromocytoma and Paraganglioma Treatment (PDQ®)–Patient Version. National Cancer Institute website. Available at: https://www.cancer.gov/types/pheochromocytoma/patient/pheochromocytoma-treatment-pdq. Updated August 18, 2017 Accessed August 24, 2017.

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