Pheochromocytoma / Paraganglioma
Pheochromocytoma or Paraganglioma are the tumour arising from Chromaffin cells of adrenal and extraadrenal origin.
These tumours are rare but can have fatal outcome if not treated appropriately. Symptoms are due to excessive production of hormones like adrenaline & Nor-adrenaline, that regulates the blood pressure.
Usually patient presents with episodic rise in blood pressure along with triad of
- Headache (80%)
- Palpitation (64%)
- Sweating (57%).
All three together has a sensitivity and specificity of 90.9% and 93.8% respectively. It can also present like heart attack, stroke etc. High 24hrs urinary or plasma fractional metanephrines are diagnostic of this disease. Any association with other tumour should be ruled out before making final intervention (Like MEN Syndrome, VHL etc.) especially in young patients.
Treatment included optimal preparation with alpha and blockers , to be followed by minimal invasive surgery. Usually hospitals with good preoperative care facility should handle these type of cases.