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ADRENAL PHEOCHROMOCYTOMA

(ENDOCRINE HYPERTENSION)
Adrenal pheochromocytoma

WHAT YOU NEED TO KNOW:

What is adrenal pheochromocytoma? Adrenal pheochromocytoma is a tumor that forms on adrenal glands. These tumors are usually benign (not cancer). Rarely, they are malignant (cancer) and need more treatment. The tumor causes your adrenal glands to make too much adrenal hormone. Adrenal hormones help your body handle stress, and keep your blood sugar and blood pressure levels normal. They also increase your levels of adrenaline. This can cause a sudden increase in your heart rate and blood pressure called a hypertensive crisis. Hypertensive crisis is a life-threatening condition that needs immediate treatment.

What causes adrenal pheochromocytoma? Adrenal pheochromocytoma can be sporadic or hereditary. Sporadic means it was caused by changes or problems with your genes. Hereditary means it was passed to you from your parents. You are more likely to develop adrenal pheochromocytoma if you have a family member with a related disorder, such as neurofibromatosis or von Hippel-Lindau disease.

What are the signs and symptoms of adrenal pheochromocytoma? The most common sign is sudden and repeated attacks of high blood pressure. The high blood pressure can cause a severe headache and increase your heart rate, palpitations, and sweating. These attacks may occur every day or every few months. You may also have any of the following:

  • Fatigue and body weakness

  • Flushed or pale skin

  • Nausea, vomiting, or a fever

  • Nervousness and anxiety

  • Pain in the abdomen, chest, lower back, or groin

  • Trouble breathing

  • Weight loss

What may trigger a hypertensive crisis?

  • Certain medicines

  • Certain dyes used during tests such as x-ray

  • Aged foods or beverages, such as cheese and red wine

  • Injuries or trauma

  • Physical exertion or stress

  • The adrenal tumor is touched during surgery

How is adrenal pheochromocytoma diagnosed? Your healthcare provider will ask about your symptoms and when they started. He may ask about your medical and family history. He will ask about the medicines you take since certain medicines can trigger a hypertensive crisis. You may also need any of the following:

  • Blood and urine tests: These tests measure the amount of adrenal hormones in your body.

  • Genetic screening: Your genes are tested to confirm that you have adrenal pheochromocytoma.

  • Imaging tests: You may be given contrast material through an IV to make the images clearer. Your healthcare provider will choose a type of contrast material that will not trigger a hypertensive crisis. Tell your healthcare provider if you are allergic to shellfish (lobster, crab, or shrimp). You may also be allergic to some types of contrast material.
    • CT scan: An x-ray machine uses a computer to take pictures of your adrenal glands.

    • MRI: An MRI uses magnetic waves to take pictures of your adrenal glands. You will need to lie still during a MRI. Never enter the MRI room with any metal objects. Metal can cause serious injury. Tell your healthcare provider if you have any metal implants in your body.

    • PET scan: A PET scan shows how much blood is flowing to your adrenal glands, and if there is cancer.

    • Scintigraphy: Scintigraphy tests the flow of blood through the adrenal glands.

How is adrenal pheochromocytoma treated?

  • Medicines: You may need medicines to lower your blood pressure, make your heartbeat regular, and control your pain or other symptoms.

  • Surgery: Healthcare providers may do surgery to remove part or all of your adrenal gland.

  • Cancer treatment: Malignant adrenal pheochromocytoma may need chemotherapy or radiation treatments.

What are the risks of adrenal pheochromocytoma?

  • You may have side effects from your medicines. You may bleed heavily during surgery. Your stomach, intestines, blood vessels, or kidneys may get injured during surgery. You could also get an infection after surgery. Even with surgery, your tumor may come back.

  • Without treatment, your blood pressure may rise to dangerous levels. This may lead to life-threatening medical problems, such as heart failure or stroke. A malignant adrenal pheochromocytoma can spread to other parts of your body. Once cancer spreads, it becomes more difficult to treat. The earlier an adrenal pheochromocytoma is treated, the better your chances that serious medical problems may be prevented.

Where can I get more information?

  • National Cancer Institute
    6116 Executive Boulevard, Suite 300
    Bethesda , MD 20892-8322
    Phone: 1- 800 - 422-6237
    Web Address: http://www.cancer.gov

When should I contact my healthcare provider? Contact your healthcare provider if:

  • You have a fever, chills, or feel weak and achy.

  • You have nausea or vomiting and cannot keep food or liquids down.

  • Your pain is worse or does not go away even after you take your pain medicines.

  • Your skin is itchy, swollen, or has a rash.

  • Your wound is tender, swollen, red, or has pus coming from it.

  • You have questions or concerns about your condition or care.

When should I seek immediate care? Seek care immediately or call 911 if:

  • You have a severe headache or feel dizzy.

  • You have blurred or double vision.

  • You have trouble breathing or a fast heartbeat.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.