Adrenal Pheochromocytoma

What is adrenal pheochromocytoma?

Adrenal pheochromocytoma is a tumor that forms on adrenal glands. These tumors are usually benign (not cancer). Rarely, they are malignant (cancer) and need more treatment. The tumor causes your adrenal glands to make too much adrenal hormone. Adrenal hormones help your body handle stress, and keep your blood sugar and blood pressure levels normal. They also increase your levels of adrenaline. This can cause a sudden increase in your heart rate and blood pressure called a hypertensive crisis. Hypertensive crisis is a life-threatening condition that needs immediate treatment.

What causes adrenal pheochromocytoma?

Adrenal pheochromocytoma can be sporadic or hereditary. Sporadic means it was caused by changes or problems with your genes. Hereditary means it was passed to you from your parents. You are more likely to develop adrenal pheochromocytoma if you have a family member with a related disorder, such as neurofibromatosis or von Hippel-Lindau disease.

What are the signs and symptoms of adrenal pheochromocytoma?

The most common sign is sudden and repeated attacks of high blood pressure. The high blood pressure can cause a severe headache and increase your heart rate, palpitations, and sweating. These attacks may occur every day or every few months. You may also have any of the following:

• Fatigue and body weakness.
• Flushed or pale skin.
• Nausea, vomiting, or a fever.
• Nervousness and anxiety.
• Pain in the abdomen, chest, lower back, or groin.
• Trouble breathing.
• Weight loss.

What may trigger a hypertensive crisis?

• Certain medicines.
• Certain dyes used during tests such as X-ray.
• Aged foods or beverages, such as cheese and red wine.
• Injuries or trauma.
• Physical exertion or stress.
• The adrenal tumor is touched during surgery.

How is adrenal pheochromocytoma diagnosed?

Your healthcare provider will ask about your symptoms and when they started. He may ask about your medical and family history. He will ask about the medicines you take since certain medicines can trigger a hypertensive crisis. You may also need any of the following:

• Blood and urine tests: These tests measure the amount of adrenal hormones in your body.
• Genetic screening: Your genes are tested to confirm that you have adrenal pheochromocytoma.
• Imaging tests: You may be given contrast material through an IV to make the images clearer. Your healthcare provider will choose a type of contrast material that will not trigger a hypertensive crisis. Tell your healthcare provider if you are allergic to shellfish (lobster, crab, or shrimp). You may also be allergic to some types of contrast material.
  • CT scan: An X-ray machine uses a computer to take pictures of your adrenal glands.
  • MRI: An MRI uses magnetic waves to take pictures of your adrenal glands. You will need to lie still during a MRI. Never enter the MRI room with any metal objects. Metal can cause serious injury. Tell your healthcare provider if you have any metal implants in your body.
  • PET scan: A PET scan shows how much blood is flowing to your adrenal glands, and if there is cancer.
  • Scintigraphy: Scintigraphy tests the flow of blood through the adrenal glands.

How is adrenal pheochromocytoma treated?

• Medicines: You may need medicines to lower your blood pressure, make your heartbeat regular, and control your pain or other symptoms.
• Surgery: Healthcare providers may do surgery to remove part or all of your adrenal gland.
• Cancer treatment: Malignant adrenal pheochromocytoma may need chemotherapy or radiation treatments.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You always feel dizzy when you stand up from a sitting or lying position.
• You hear voices or see something that is not real.
• You have severe pain in your stomach, waist, or back.
• You have very dry skin, dry mouth and tongue, or feel more thirsty than normal.
• Your symptoms become worse, even after you take medicine.

When should I call my healthcare provider?

Call your healthcare provider if:

• You have a fever.
• You have diarrhea or constipation.
• You have nausea, vomiting, or stomach pain.
• You sweat or urinate more than usual.
• You have questions or concerns about your condition, treatment, or care.