Pheochromocytoma- Diagnosis and Treatment

Overview

Pheochromocytomas are uncommon neuroendocrine tumors that typically grow slowly. They originate from cells in the adrenal medulla, the adrenal gland’s core. Often, pheochromocytoma can be effectively treated and controlled if caught early. Although there are choices, surgery to remove the tumor or tumors is the preferred course of treatment when it is feasible. Usually, surgical intervention reduces symptoms and brings blood pressure back to normal.  

What is Pheochromocytoma?

A rare tumor that develops in an adrenal gland is called a pheochromocytoma. The tumor is not usually cancerous which is also termed a benign tumor. There is one adrenal gland on top of each kidney. The hormones produced by the adrenal glands aid in regulating vital bodily functions including blood pressure. A pheochromocytoma often affects just one adrenal gland. However, cancers can develop in any of the two adrenal glands.

Hormones released by a pheochromocytoma tumor might result in a variety of symptoms. These include headaches, perspiration, elevated blood pressure, and panic attack symptoms. Serious or even fatal harm to other bodily systems may result from untreated pheochromocytomas.

There are three stages of pheochromocytoma:

• Local Pheochromocytoma: The tumor is still inside the adrenal gland where it first appeared and has not spread.
• Regional Pheochromocytoma: Adjacent tissues or lymph nodes may have been affected by the tumor.
• Metastatic Pheochromocytoma: The tumor has extended to other locations.

Symptoms of Pheochromocytoma

Pheochromocytomas might sometimes cause no symptoms at all. The following symptoms of pheochromocytoma are frequently present: 

• High blood pressure
• Prolonged perspiration
• Quick heartbeat
• Restless shaking in certain individuals
• Pale Skin
• Breathing difficulty
• Symptoms similar to a panic attack, such as sudden, overwhelming terror
• Fear or a feeling of impending calamity
• Issues with vision
• Constipation
• Loss of weight

The Pheochromocytoma Diagnosis

Diagnosis of pheochromocytoma will include the following.

• Genetic Tests: The healthcare provider may advise genetic testing to determine whether a pheochromocytoma is associated with a hereditary disorder. This will include several tests the doctor will carry out to assess pheochromocytoma.
• 24-hour Urine Analysis: For 24 hours, a urine sample is required for analysis to determine the correct diagnosis of the condition.

• Blood Test: A medical practitioner draws blood to be examined in the 

Laboratory.

• Lab Tests: The hormones noradrenaline and adrenaline, as well as chemicals known as metanephrines that might result from these hormones, are measured in these tests. There is a greater likelihood of elevated metanephrine levels in pheochromocytoma patients.
• Imaging Tests: Imaging studies are required if the lab test results reveal evidence of a pheochromocytoma. The doctor may request one or more of these tests to determine a tumor. Among these tests are the following:
• MRI
• M-iodobenzylguanidine (MIBG) imaging
• Positron emission tomography, or PET scans
• CT Scan

Treatment for Pheochromocytoma

The size of the tumor affects the treatment options for pheochromocytoma, among other things.

• Whether the tumor is malignant or benign
• Elevated catecholamine symptoms
• If the tumor is localized or has metastasized—that is, it has spread to other parts of your body
• If the tumor has recurred or has been diagnosed for the first time

The treatment options for pheochromocytoma are:

• Medications: The doctor may prescribe medicine to treat symptoms if pheochromocytoma is causing an overabundance of adrenal hormones. For instance, medications will be advised to maintain normal blood pressure and heart rate.
• Surgery: The primary therapy for pheochromocytoma is surgery. Ninety percent of pheochromocytomas can be surgically removed with success. To determine whether the tumor has spread, the surgeon will examine the lymph nodes and surrounding tissue during the procedure. After surgery, the doctor will measure the catecholamine levels in blood or urine following surgery. A normal level of catecholamines indicates the complete removal of pheochromocytoma cells.
• Radiation Treatment: Strong beams of energy are focused during radiation therapy to either kill or stop the growth of cancer cells while preserving as much surrounding healthy tissue as feasible. There are two types of radiation therapies:
• External Radiation Therapy
• Internal Radiation Therapy
• Ablation Therapy: One safe therapeutic approach for tumor destruction is ablation therapy, which employs extremely high or extremely low temperatures. The following ablation techniques can aid in the death of cancerous and aberrant cells:
• Cryoablation
• Radiofrequency Ablation
• Embolization Treatment: Embolization therapy is a type of pheochromocytoma treatment in which the artery that supplies the adrenal gland is blocked. The cancer cells that are proliferating in the adrenal glands can be killed by cutting off the blood supply to them.
• Targeted Therapy: One type of treatment called targeted therapy involves using drugs or other substances to target particular cancer cells while sparing healthy ones. Medical professionals treat recurring and metastatic pheochromocytomas using targeted medicines.

Conclusion

Although phaeochromocytoma is an uncommon tumor, it’s vital to be aware of the risk of receiving this diagnosis since the symptoms and indications these tumors produce can be harmful. Even while palpitations, anxiety, and high blood pressure are frequent symptoms, it’s crucial to consult a doctor if they happen simultaneously, particularly during episodes.

Acquiring knowledge about pheochromocytoma symptoms might facilitate the process of diagnosing the condition. Comprehending the situation will aid in making appropriate inquiries and obtaining the care for the same.

Frequently Asked Questions

1. How often do pheochromocytomas occur?

Uncommon tumors are pheochromocytomas. Since many pheochromocytoma patients don’t exhibit symptoms and are misdiagnosed, the actual number of instances needs to be clarified. Pheochromocytomas occur in less than 1% of high blood pressure patients.

2. When should I contact a doctor?

Speak with a doctor if you have headaches and elevated blood pressure, which are signs of pheochromocytoma. Pheochromocytoma is uncommon, therefore treating high blood pressure is crucial even if the chance of developing it is minimal.

3. Can pheochromocytomas be avoided?

Sadly, there is no way to stop a pheochromocytoma from growing. Genetic counseling can assist test for pheochromocytomas and can help to identify them in their early stages if at risk of acquiring one owing to specific inherited disorders and genes.

4. Who is affected by pheochromocytomas?

Pheochromocytomas can affect anybody at any age, however, they often strike those in the 30 to 50 age range. Children account for around 10% of instances.