Pheochromocytoma
Anesthetic relevance Critical
Anesthetic management {{{anesthetic_management}}}
Specialty Endocrinology
Signs and symptoms Hypertension

Headache Diaphoresis

Tachycardia
Diagnosis Urine metanephrines and catecholamines Abdominal CT/MRI for localization
Treatment Surgical resection Alpha/beta blockade


Pheochromocytoma is a rare neuroendocrine disease of the adrenal gland where catecholamine-secreting tumors cause hypertension. Pheochromocytoma is present in 0.05%[1] - 0.2%[2] of hypertensive individuals, the incidence of the disease presents equally between men and women with a distribution across age groups but peaks in between 40 and 50 years of age. The classic presentation of the disease is a triad of symptoms including headache, palpitations, diaphoresis with a documented clinical sign of hypertension (present in 90% of patients with pheochromocytoma)[3]. However, patients can often present with less definitive symptoms such as tremor, anxiety, flushing, weight loss, and hyperglycemia. While the majority of pheochromocytoma emerges from adrenal tumors, roughly 15-20% can be extra-adrenal in etiology.

Anesthetic implications

Preoperative optimization

Intraoperative management

Postoperative management

Related surgical procedures

Pathophysiology

Signs and symptoms

Diagnosis

Treatment

Medication

Surgery

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Epidemiology

References

  1. Lo, Chung-Yau; Lam, King-Yin; Wat, Ming-Sun; Lam, Karen S. (2000-03-01). "Adrenal pheochromocytoma remains a frequently overlooked diagnosis". The American Journal of Surgery. 179 (3): 212–215. doi:10.1016/S0002-9610(00)00296-8. ISSN 0002-9610. PMID 10827323.
  2. Yeh, Michael; Livhits, Masha; Duh, Quan-Yang (2022). "The Adrenal Glands". Sabiston textbook of surgery : the biological basis of modern surgical practice. Courtney M., Jr. Townsend, R. Daniel Beauchamp, B. Mark Evers, Kenneth L. Mattox, David C. Sabiston (21st ed.). St. Louis, Missour. ISBN 978-0-323-64064-0. OCLC 1235959889.
  3. Peramunage, Dasun; Nikravan, Sara (2020-03-01). "Anesthesia for Endocrine Emergencies". Anesthesiology Clinics. 38 (1): 149–163. doi:10.1016/j.anclin.2019.10.006. ISSN 1932-2275. PMID 32008649.