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Pheochromocytoma: current diagnosis and management
1National Hypertension Association, New York, NY 10016.
Cleveland Clinic Journal of Medicine
|September 1, 1993
Summary
Pheochromocytoma, a rare tumor, causes hypertension due to excess catecholamines. Early diagnosis and surgical treatment are crucial for survival, as it can mimic other conditions.
Area of Science:
- Endocrinology
- Oncology
Background:
- Pheochromocytoma originates from chromaffin cells, leading to catecholamine excess and hypertension.
- This condition can present with varied symptoms, making diagnosis challenging.
Purpose of the Study:
- To comprehensively review the clinical presentation of pheochromocytoma.
- To outline diagnostic strategies for pheochromocytoma.
- To discuss current treatment modalities for pheochromocytoma.
Main Methods:
- Review of clinical manifestations, diagnostic tests, and treatment outcomes.
- Emphasis on biochemical assays (plasma and urine catecholamines/metabolites) and imaging (MRI).
- Inclusion of the clonidine suppression test for diagnostic specificity.
Main Results:
- Pheochromocytoma symptoms are primarily due to hypercatecholaminemia and hypertension.
- Diagnostic challenges arise as catecholamine levels may normalize between episodes.
- Magnetic resonance imaging (MRI) is identified as the most reliable tumor localization method.
Conclusions:
- Pheochromocytoma should be suspected in patients with hypertension, especially with accompanying symptoms.
- The clonidine suppression test enhances diagnostic specificity.
- Surgical resection offers a high success rate (90%), but untreated disease is fatal.
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