Phaeochromocytoma

Question 1

What is as phaeochromocytoma.

Answer 1

A rare catecholamine producing tumour.

Question 2

Where do phaeos arise from.

Answer 2

Sympathetic paraganglia cells (phaeochrome bodies) which are collections of chromaffin cells.

Question 3

Where are phaeos usually found.

Answer 3

Within the adrenal medulla.

Question 4

How common are extra-adrenals tumours (paragangliomas).

Answer 4

Rare.

Question 5

Where are extra-adrenal tumours usually found.

Answer 5

Often found by the aortic bifurcation (the organs of Zuckerkandl).

Question 6

What rule do phaeos kindof follow…..

Answer 6

10% rule.

Question 7

What is the 10% rule of phaeos. (4)

Answer 7

10% are malignant.
10% are extra-adrenal.
10% are bilateral.
10% are familial.

Question 8

What is the main side effect of a phaeo.

Answer 8

They are treatable but malignant causes of hypertension (

Question 9

What are the associations of phaeos. (2)

Answer 9

90% are sporadic.

10% are part of hereditary cancer syndromes.

Question 10

What is the classical triad of phaeos. (3)

Answer 10

Episodic headache.
Sweating.
Tachycardia (with raised, low or normal BP).

Question 11

What is seen on the blood tests of a patient with a phaeo.

Answer 11

Raised WCC.

Question 12

What are the cardiovascular features of phaeos. (7)

Answer 12

Raised pulse. 
Palpitations/VT.
Dyspnoea. 
Faints. 
Angina. 
MI/LVF. 
Cardiomyopathy.

Question 13

What are the CNS features of phaeos. (9)

Answer 13

Headache. 
Visual disorder. 
Dizziness. 
Tremor. 
Numbnesss. 
Fits. 
Encephalopathy. 
Horner's syndrome. 
Subarachnoid/CNS haemorrhage.

Question 14

What are the psychological features of phaeos. (5)

Answer 14

Anxiety. 
Panic. 
Hyperactivity. 
Confusion. 
Episodic psychosis.

Question 15

What are the GI features of phaeos. (4)

Answer 15

DandV.
Abdominal pan over tumour site.
Mass.
Mesenteric vasoconstriction.

Question 16

What other features are associated with phaeos. (6)

Answer 16

Sweats/flushes. 
Heat intolerance. 
Pallor. 
Raised temperature. 
Backache. 
Haemoptysis.

Question 17

What is the main thing to take into account about the symptoms of phaeos.

Answer 17

They are often episodic and vague.

Question 18

What are some precipitants for the symptoms of phaeos. (8)

Answer 18

Straining. 
Exercise. 
Stress. 
Abdominal pressure. 
Surgery. 
Beta blockers. 
IV contrast agents. 
Tricyclics.