Pheochromocytoma

Pheochromocytoma is a disease caused by a benign or malignant tumor of adrenal chromaffin tissue or adenocarpal localization.

Pathogenesis. Excess production of catecholamines (epinephrine, norepinephrine). Symptoms. Characteristic crises with a sharp increase in blood pressure in combination with neuro-psychic, endocrine, metabolic, gastrointestinal and hematological symptoms (paroxysmal form of the disease). During the attack, the clinic resembles sympathic-adrenal. Crisis: there is a feeling of fear, anxiety, shivering, chills, pallor of the skin, headache, chest pain, heart region, tachycardia, extrasystole, nausea, vomiting, fever, sweating, dry mouth. In the blood-leukocytosis, lymphocytosis, eosinophilia, hyperglycaemia. The attack ends with polyuria. The duration of the crisis is from several minutes to several hours. The crisis can be complicated by a hemorrhage in the retina of the eye, a violation of the cerebral circulation, pulmonary edema. Attacks occur, as a rule, suddenly and can be provoked by emotional stress, physical stress, palpation of the tumor, a sharp change in the position of the body. With a stable form of the disease, there is constantly high hypertension, there may be disturbances in the functional state of the kidneys, changes in the fundus of the eye. Observed increased excitability, mood lability, fatigue, headache. With malignant tumors - pheochromoblastoma - weight loss, abdominal pain are not uncommon. Possible development of diabetes. For diagnostic purposes, ultrasound examination of the adrenal glands, computed tomography, retropneumoperitoneum (topical diagnosis), urine excretion (within a day or in a three-hour portion of urine collected after an attack) of catecholamines and their metabolites: epinephrine, noradrenaline, vanillylmandelic acid, pharmacological tests With histamine or tropafen.

Surgical treatment (tumor removal). To stop the crisis apply tropafen.