Pheochromocytoma

Pheochromocytoma

Pheochromocytoma is a type of neuroendocrine tumor that grows from cells called chromaffin cells. These cells produce hormones needed for the body and are found in the adrenal glands.

Pheochromocytomas are benign tumors of the chromaffin tissues arising from the adrenal glands or sympathetic ganglia along the spinal column. They secrete catecholamine like noradrenalin and adrenaline

Clinical Presentation
  • headaches
  • heavy sweating
  • a rapid heartbeat (tachycardia)
  • high blood pressure
  • a pale face
  • feeling of being sick
  • feeling anxious or panicky
  • shakiness (tremor)
  • paroxysmal hypertension
  • flustering (agitation)
  • chest discomfort
Diagnosis
  •  Associated with the 5 H’s— hypertension, headache, hyperhidrosis, hypermetabolism and  hyperglycemia, 
  •  Urinary catecholamine are direct and conclusive tests
  •  Serum epinephrine and norepinephrine levels will be elevated.
  •  Must avoid coffee, tea, bananas, chocolate, vanilla and ASA, nicotine, amphetamines, decongestants before 24h urine testing
  •  Clonidine suppression test— in normal individual, would block catecholamine release
  •  Imaging studies i.e CT Scan and MRI

How the tumour affects the adrenal glands
The adrenal glands make the hormones adrenaline and noradrenaline, which are released into the bloodstream when needed. These hormones control heart rate, blood pressure and metabolism (the chemical processes that keep your organs working).

A phaeochromocytoma can cause the adrenal glands to produce too much of these hormones, which often results in problems such as heart palpitations and high blood pressure.

Management
Treating a phaeochromocytoma

Surgery to remove the phaeochromocytoma is the treatment of choice since most of the surgeries are successful

  • Alpha blockers (and in some cases beta blockers) for several weeks before the operation. They block the effects of the excess hormones on the body and stabilize your heart rate and blood pressure.

The operation is carried out may include

  • “keyhole” (laparoscopic) surgery – a number of small cuts (incisions) are made and fine instruments are passed through these to remove the tumour; this is the most common type of surgery for phaeochromocytomas
  • open surgery – a single larger incision is made in the skin to access and remove the tumour
    The incisions will usually be made in your tummy (abdomen).

If  phaeochromocytoma is cancerous,  chemotherapy or radiotherapy in addition to surgery.

Nursing Care

As  given to patients from surgery, and according to the treatment given.

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4 thoughts on “Pheochromocytoma”

    1. False.

      While alpha blockers are used in the treatment of pheochromocytoma, carvedilol is not typically used for this purpose. Carvedilol is a beta-blocker with some alpha-blocking activity, but it is not considered a first-line treatment for pheochromocytoma. Instead, alpha blockers such as phenoxybenzamine and prazosin are more commonly used to control hypertension and other symptoms associated with this condition.

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