Pheochromocytoma

Pheochromocytoma is a rare tumor that develops in an adrenal gland. These small glands sit above your kidneys and make hormones that affect your blood pressure, heart rate, blood sugar, and response to stress.

A pheochromocytoma can release too much epinephrine and norepinephrine, hormones also known as catecholamines. This can cause high blood pressure, a racing heart, sweating, headaches, and other symptoms that may come and go.

It’s not always clear why a pheochromocytoma develops. Some tumors are linked to genetic changes that can run in families.

Inherited conditions linked to pheochromocytoma include:

• Multiple endocrine neoplasia type 2
• Von Hippel-Lindau syndrome
• Neurofibromatosis type 1
• Hereditary paraganglioma-pheochromocytoma syndromes

You may have an inherited condition even without a known family history. Because of this, genetic counseling and testing may be recommended after diagnosis.

Stress, exercise, surgery, anesthesia, and some medications can trigger symptoms in someone who already has pheochromocytoma, but they don’t cause the tumor.

High blood pressure is one of the most common signs of pheochromocytoma. It may stay high throughout the day or suddenly rise during an episode. In some people, it’s difficult to control even with blood pressure medicine.

Other symptoms may include:

• Severe or pounding headaches
• Heavy sweating
• A fast, pounding, or irregular heartbeat
• Shaking or trembling
• Anxiety or a sudden feeling of fear
• Chest or abdominal discomfort
• Nausea
• Shortness of breath
• Weakness or fatigue
• Unexplained weight loss

Symptoms can start suddenly and last for several minutes or longer. Because episodes can cause a racing heart, sweating, and anxiety, they may feel similar to panic attacks.

Some people have few or no symptoms. In these cases, a pheochromocytoma may be found during a CT scan or MRI done for another reason.

Seek emergency care for a sudden severe headache, fainting, severe shortness of breath, confusion, new weakness or numbness, or possible signs of a heart attack or stroke.

Blood or urine tests can check for high levels of hormones made by the adrenal glands.

If the results suggest pheochromocytoma, a CT scan or MRI can help find the tumor. Specialized imaging, such as a PET or MIBG scan, may be needed if the tumor is difficult to find or your doctor is concerned that it has spread.

Genetic counseling and testing may also be recommended.

Surgery to remove the tumor and affected adrenal gland is the most common treatment when the tumor hasn’t spread.

Medication is used before surgery to control your blood pressure. That can lower the risk of dangerous hormone-related changes during the procedure.

If the tumor has spread or can’t be completely removed, other treatments may include:

• Radiation-based treatment
• Chemotherapy
• Targeted therapy
• Ablation
• Embolization

Pheochromocytoma can cause dangerous spikes in blood pressure and put serious stress on the heart and blood vessels. Without treatment, it can lead to problems such as abnormal heart rhythms, heart damage, heart attack, stroke, or kidney damage.

Long-term follow-up is also important because pheochromocytoma can sometimes return after treatment.

If you have unexplained blood pressure spikes or other symptoms of pheochromocytoma, or an adrenal tumor was found during an imaging test, see an endocrinologist for an evaluation.

Schedule an appointment with Diabetes & Glandular Disease Clinic in San Antonio to find out what may be causing your symptoms and what treatment you may need.

1. Is Pheochromocytoma Cancer?

Most pheochromocytomas stay in the adrenal gland, but some can spread to other parts of the body. A pheochromocytoma is considered metastatic when it has spread to other parts of the body, such as the lymph nodes, bones, liver, or lungs.

2. Can You Have Pheochromocytoma With Normal Blood Pressure?

Yes. Some people have normal blood pressure between episodes. Others have tumors that cause few or no symptoms.

3. Can Surgery Cure Pheochromocytoma?

Surgery may cure pheochromocytoma when the tumor hasn’t spread and can be completely removed. Your doctor will monitor your blood pressure and hormone levels after surgery.