Pheochromocytoma

Background

  • Rare tumor arising from chromaffin cells in adrenal medulla or other paraganglia in the body
  • Increased catecholamine production leading to its clinical manifestations

Clinical Features

Differential Diagnosis

Hypertension

Evaluation

  • Plasma free metanephrines
  • Urinary fractionated metanephrines
  • CT imaging to localize tumor
  • General lab features include hyperglycemia, hypercalcemia, and erythrocytosis

Management

  • Hypertensive crisis:
    • α blockade with phenoxybenzamine or phentolamine acutely[1]
    • nitroprusside
    • nicardipine
  • Beta blockade can be started 2 days later
  • Eventual surgical resection of tumor

Disposition

  • Admission to a monitored setting

See Also

External Links

References

  1. WJ Elliott, J Varon. Drugs used for the treatment of hypertensive emergencies. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)