Pheochromocytoma

Question 1

Pheochromocytoma

Answer 1

A rare but serious disease resulting from excess catecholamine release characterized by proximal or sustained hypertension; almost always due to a tumor of the adrenal medulla

Question 2

Pheochromocytoma Signs/Symptoms

Answer 2

Hypertension **Labile
Diaphoresis
Hyperglycemia
Severe HA
Palpitations; profuse sweating
Tremor
Tachycardia
Weight loss
Postural hypotension

Question 3

Pheochromocytoma Lab/Diagnostics

Answer 3

TSH Normal
Plasma free metnephrines
Assay of urine catecholamine, metanephrines, vanillylmadelic acid, and creatinine 24 hour urine >2.2 ug metanephrine per mg creative AND >5.5 ug VMA per mg creatinine
CT of adrenals used to confirm and localize tumor

Question 4

Pheochromocytoma Management

Answer 4

Surgical remover of tumor is treatment of choice
Alpha adrenergic medication’s preoperatively may be used
- Phentolamine 1-2mg IV every 5 minutes until controlled then 1-5mg IV every 12-24 hours
- as soon as possible, convert to PO phenoxybenzamine

Post op watch for:
- Hypotension (depleted catecholamine)
-Adrenal insufficiency
Hemorrhage