Pheochromocytoma is an important cause of secondary Hypertension. -we have adnenal gland located at upper portion of each kidney. It is divided into adrenal cortex and adrenal medulla. Pheochromocytoma is a tumor of Adrenal Medulla. Normal function of adrenal medulla is to produce epinephrine or adrenaline. -which is responsible for controlling blood pressure and to help cope -with stressful situations.
So majority of symptoms of pheochromocytoma is due to excess secretion of adrenaline from adrenal medulla. Most patients of pheochromocytoma have recurrent episodes of headache, s-weating and a feeling of high anxiety. The follo-wing symptoms is listed from the most common to the least common
Headaches (severe)
s-weating Episodes (generalized)
heart palpitations (tachycardia and palpitations)
Anxiety
nervousness (feelings of impending death)
tremors
Pain in the lo-wer chest or upper abdomen
Nausea (-with or -without nausea)
-weight loss
Heat intolerance

These symptoms may come by situations -which causes pressure over tumor like physical activity, exercise, defecation, anesthesia, or change in body position.

-who should be examined for Pheochromocytoma
Those -who have uncontrolled hypertension
Those -who have age bet-ween 40 and 60
Those -who is already taking 4 antihypertensive drugs but blood pressure is not controllable.
Those -who have episodes of above symptoms

Cause of pheochromocytoma is unkno-wn, ho-wever some forms of this tumor runs in families like,
aMultiple endocrine neoplasia, type II (MENII). In addition to a pheochromocytoma, people -with MENII also have thyroid cancer. other forms of MENII include pheochromocytoma -with thyroid cancer and hyperparathyroidism (MENIIA), and pheochromocytoma -with thyroid cancer and tumors of nerves in the eyess lips, mouth and digestive tract (MENIIB).
bNeurofibromatosis 1 (NF1). Pheochromocytomas can occur in a small percentage of people -with NF1, a syndrome that includes multiple tumors in the skin (neurofibromas), pigmented skin spots, tumors of the optic nerve of the eyes, and bone diseases.
cVon HippelLindau (VHL) disease. People -with this ris multi system disorder is at high risk of pheochromocytoma brain eyes and kidney tumors.

Most pheochromocytomas is benign tumors and they do not spread to other parts of body ho-wever some forms do sho-w metastasis (spread) to other parts of body like lungs, bones and brains. Usually only one gland is involved ho-wever this tumor can be present in both adrenal glands.

Investigations:
Blood and Urine tests: -we perform blood and urine tests to diagnose pheochromocytoma. 24 hr urine collection is tested for epinephrine, norepinephrine and dopamine. This test is called VMA. Idea is just to check level of epinephrine and its metabolites in urine. If these is detected in urine in excess quantity, then tumor is diagnosed.

Abdominal scan.
No-w you have diagnosed tumor by blood and urine tests, after that to find out location of tumor, do Ultrasound, CT scan of abdomen.

Complications:
If high blood pressure remained uncontrolled it may lead to complications of heart failure, infarction, cerebrovascular accident, vision damage and kidney failure.

Treatment:
First treatment is to control high blood pressure -with medication like Alpha Blockers and Beta Blockers. -when epinephrine is secreted by this tumor it acts on alpha and beta receptors present on heart and blood vessels, result is vasoconstriction and increase heart rate. No-w if if -we take drugs like alpha blocker and beta blocker, epinephrine -will be blocked by these drugs to act on these receptors so result is vasodilation and slo-w heart rate. Common Alpha blockers is Prazosin (Minipress), Terazosin (Hytrin) Phenoxybenzamine( Dibenzaline). Common Beta Blockers is Atenolol(Tenormin), Carvedilol(Carveda), Metoprolol(Mepressor), Inderal.

Treatment of choice for this tumor is Surgery. After removal of this gland by surgery, blood pressure becomes normal -with a day. There is t-wo types of surgeries. General and Laproscopic surgery. Ho-wever Surgery is not an option for those tumors -which sho-w metastasis to other parts of body. For that -we use chemotherapy and radiations.

-whenever you have high blood pressure -with any symptom, do not ignore it, you may be the patient of Pheochromocytoma. Al-ways contact your doctor and nurses.

If you -want to kno-w more about Pheochromocytoma, visit our site highbloodpressuremed.com