Understanding Pheochromocytoma
Photo credit: UCLA Health
Pheochromocytoma is a rare tumour that originates from the chromaffin cells of the adrenal gland, leading to excessive production of catecholamines (adrenaline and noradrenaline). These hormones control the body’s fight-or-flight response, and their excess can lead to symptoms like severe hypertension, heart palpitations, headaches, and more. While this hormonal condition is uncommon, early recognition is key for successful management.
Causes of Pheochromocytoma
Pheochromocytomas are typically caused by genetic mutations or inherited syndromes, such as:
- Multiple Endocrine Neoplasia Type 2 (MEN 2): A genetic condition that causes multiple tumours in endocrine glands.
- Von Hippel-Lindau Disease: A hereditary condition that leads to tumours in various parts of the body.
- Neurofibromatosis Type 1: A genetic disorder that causes nerve tumours and sometimes pheochromocytomas.
- Familial Pheochromocytoma: A rare genetic mutation that increases the likelihood of developing these tumours.
Sporadic Pheochromocytoma:
- The most typical form of pheochromocytoma in the adult age group is sporadic, i.e., isolated occurrence with no family history of the above genetic disorders.
- These are diagnosed during the evaluation of young-age onset hypertension or unexplained hypertension, heart disease and stroke patients.
Causes of Pheochromocytoma
Pheochromocytomas are typically caused by genetic mutations or inherited syndromes, such as:
- Multiple Endocrine Neoplasia Type 2 (MEN 2): A genetic condition that causes multiple tumours in endocrine glands.
- Von Hippel-Lindau Disease: A hereditary condition that leads to tumours in various parts of the body.
- Neurofibromatosis Type 1: A genetic disorder that causes nerve tumours and sometimes pheochromocytomas.
- Familial Pheochromocytoma: A rare genetic mutation that increases the likelihood of developing these tumours.
Sporadic Pheochromocytoma:
- The most typical form of pheochromocytoma in the adult age group is sporadic, i.e., isolated occurrence with no family history of the above genetic disorders.
- These are diagnosed during the evaluation of young-age onset hypertension or unexplained hypertension, heart disease and stroke patients.
Photo credit: Journal of Clinical Medicine
Symptoms of Pheochromocytoma
The symptoms are primarily due to the excess hormones and often occur episodically. Common symptoms include:
- High Blood Pressure: Severe hypertension that may be persistent or occur in episodes.
- Heart Palpitations: Rapid, fluttering, or pounding heartbeats, often associated with high blood pressure spikes.
- Headaches: Frequent and severe headaches, often debilitating.
- Excessive Sweating: Sweating even without exertion or a temperature rise.
- Panic Attack-like Symptoms: Feelings of anxiety or panic with rapid breathing and a sense of impending doom.
- Pallor: Unusual paleness during episodes, sometimes followed by facial flushing.
- Abdominal Pain: Some patients may experience nausea and abdominal discomfort.
- Unintentional Weight Loss: Unexplained weight loss despite having a good appetite due to increased metabolism.
- Stroke or heart issues at a young age
If you are experiencing any of the symptoms described above, it is important to seek the advice of an endocrinologist in Singapore to prevent various complications. Some of the key complications include hypertensive crisis (sudden, extreme increases in blood pressure), arrhythmias (irregular heartbeats), and heart failure.
Diagnosis of Pheochromocytoma
At Harmony Thyroid, Endocrinology and Diabetes Centre, our experienced endocrinologist, Dr Vikram Sonawane, will typically conduct the following tests:
- Biochemical Testing: Blood or 24-hour urine tests to measure catecholamines and metanephrines.
- Imaging Tests: CT scans or MRIs of the abdomen to visualise the tumour. MIBG scintigraphy may be required for further confirmation.
Treatment Options for Pheochromocytoma
Surgical removal of the tumour is the primary treatment. Dr Vikram will collaborate with an endocrine surgeon to effectively treat and manage your condition:
- Preoperative Management: Endocrinologists manage hypertension and prepare the patient for surgery with medications like alpha-blockers and beta-blockers to control blood pressure and prevent complications during surgery.
- Postoperative Care: After surgery, endocrinologists monitor hormone levels, blood pressure, and any signs of recurrence. They may also manage any related long-term health effects.
Managing Life with Pheochromocytoma
Life after surgery involves regular follow-ups to monitor hormone levels and check for tumour recurrence. Patients are advised to avoid triggers for episodes, and medications may be prescribed to manage hypertension and other symptoms. Close communication with an endocrinologist in Singapore is essential for long-term management of pheochromocytoma.
If you or your loved ones are suffering from pheochromocytoma, you can schedule an appointment with our Endocrinologist, Dr Vikram, from Harmony Thyroid, Endocrinology, and Diabetes Centre. He is an expert in pheochromocytoma and can thus help you to take charge of your hormonal condition.
