Pheochromocytoma

Overview

What is a Pheochromocytoma?

A pheochromocytoma is an uncommon and usually benign, or noncancerous tumor, that can develop on your adrenal gland.  The adrenal glands produce multiple hormones and rest directly above each of your kidneys. This tumor, or growth of cells, can cause an excess release of hormones that can lead to high blood pressure, anxiety, headaches, heart palpitations, and other symptoms. 

Can Pheochromocytoma be cancerous? Most pheochromocytomas are benign, meaning they are not cancerous and cannot spread to other parts of the body. However, 10-15% of pheochromocytomas will be cancerous.

Symptoms

What are the symptoms of a pheochromocytoma?
Pheochromocytoma is most often diagnosed in individuals between the ages of 20-50, who may present with any of the following signs or symptoms:

• High blood pressure
• Headaches
• Excessive sweating
• Rapid or irregular heartbeat
• Shortness of breath
• Tremors
• Pallor, or loss of color in the face
• Panic attack-type or increased anxiety symptoms

What exacerbates symptoms of a pheochromocytoma?

Symptoms can be constant or can be exacerbated or triggered by the following:

• Physical or emotional stress including:
  • Physical exertion 
  • Surgery 
  • Labor and delivery
• Foods: If rich in tyramine content, foods can trigger blood pressure symptoms. Foods that are fermented, rancid, cured, or preserved tend to be rich in tyramine content. These include some cheeses, beers or wines, chocolates, and dried or smoked meats. 
• Drugs or medications: 
  • Stimulants, like amphetamines or cocaine
  • Antidepressants like Amitriptyline, Doxepin, or Imipramine
  • Anesthesia
  • Beta-blockers 

Diagnosis

How is a Pheochromocytoma diagnosed?
Pheochromocytoma can be hard to diagnose since symptoms are nonspecific and can mimic other diseases. Genetic testing can help with diagnosis in individuals with a family history of pheochromocytoma.  Furthermore, if a doctor suspects that you have a pheochromocytoma, you may undergo any of the following diagnostic tests:

• Blood or urine tests to look for elevated stress-hormone levels
• An MRI or CT scan to check for a tumor

Treatment

How is pheochromocytoma treated?

Treatment for a pheochromocytoma typically involves the removal of the tumor. It will be up to the doctor’s discretion based on the extent of the tumor, to determine what is being removed. If the pheochromocytoma exists on both adrenal glands, the doctor may choose to just remove the tumors. If the pheochromocytoma exists on just one gland, the doctor may remove the tumor and the gland together, since the other adrenal gland will work to compensate. If the pheochromocytoma is cancerous, chemotherapy or radiation may be necessary. 

References

MacMillan, A. (n.d.). Pheochromocytoma: Symptoms, Causes, Treatment, and Prognosis. WebMD. https://www.webmd.com/cancer/what_is_pheochromocytoma.

Mayo Foundation for Medical Education and Research. (2020, March 3). Pheochromocytoma. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pheochromocytoma/symptoms-causes/syc-20355367. 

https://medlineplus.gov/genetics/condition/autoimmune-addison-disease/#inheritance.