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Pheochromocytoma


Pheochromocytoma is a tumour of the chromaffin tissue which secretes catecholamines i.e. Adrenaline n noradrenaline.
90%of the tumour arise frm the adrenal medulla,but it can also occur anywhere on sympathetic chain.
Neurofibromatosis is associated with an increased incidence of pheochromocytoma.
C/O-
paroxysmal hypertension associated which episode of pallor or flushing,palpitation,sweating,headahe n anxiety.
Gastrointestinal symptos like abdominal pain,vomitting,constipation n wt loss.
Glucose intolerence.
Complications of hypertension like stroke,myocardial infarction n left venticular failure..
Investigations_
24 hr urine vanillylmandelic acid is raised.
24 hr urine metanephrines raised. 24 hr urine free catecholamines raised.
Plasma noradrenaline n adrenaline leve r raised.
Provocative n adrenolytic test r rarely required.
CT scan n scintigraphy can localised the tumour.
Selective venous sampling with measurement of plasma noradrenaline can b localised tumour in difficult case.
Management_
Excision of the the tumour if possible.
If excision is not possible löng term treatment with alpha n beta adrenoreceptor blockin drug like propranolol,betalol is advocated..Beta blocker shoult nt b given alone.

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