Pheochromocytoma is a benign tumor that develops in the adrenal glands, located on the kidneys. Although this type of tumor does not put your life at risk, it can produce various health problems, especially because the adrenal glands produce hormones that regulate the functioning of almost every organ of the body.
Thus, because hormones are not produced correctly due to the presence of the tumor, it is common for the appearance of high blood pressure not to decrease and other cardiovascular problems.
Therefore, even though it is not a malignant cancer, in most cases, pheochromocytoma must be removed through surgery to prevent injury to other organs over time.
What are the main symptoms
The symptoms of this type of tumor are more frequent in the 20 to 50 years and include:
- High blood pressure;
- Increased heart rate;
- Excess sweat;
- Severe headache;
- Tremors;
- Pallor on the face;
- Sensation of shortness of breath.
Usually these symptoms of pheochromocytoma arise in seizures that last between 15 to 20 minutes, and can happen more than once a day. However, blood pressure can always remain high and is difficult to control.
These crises of symptoms are most common after situations such as exercising, being very nervous or anxious, changing body position, using the bathroom or eating foods rich in tyrosine, such as some cheeses, avocado or smoked meat. See a more complete list of foods rich in tyrosine.
How is the diagnosis made?
To confirm the diagnosis of pheochromocytoma the doctor may order several tests such as blood tests that measure the hormones produced by the adrenal glands, such as adrenaline or noradrenaline, as well as computed tomography or magnetic resonance imaging tests that evaluate the structure of the adrenal glands.
How is the treatment done?
The best form of treatment for pheochromocytoma is to have surgery to remove the tumor from the affected adrenal gland. However, before taking the surgery, your doctor may prescribe some medicines that help regulate the pressure and decrease the risk of complications, such as:
- Alpha blockers, such as Doxazosin or Terazosin: improve blood circulation and reduce high blood pressure;
- Beta blockers, such as Atenolol or Metoprolol: decrease heart rate and keep blood pressure under control;
- Other high blood pressure medications, such as Captopril or Amlodipine: are used when blood pressure does not decrease only with the use of alpha or beta blockers.
These medications are usually used for a period of about 10 days prior to surgery.
When the pressure is controlled, it is usually possible to perform surgery to remove the tumor. In most cases, the entire adrenal gland is removed during surgery, however, if the other gland has also been removed, the surgeon attempts to remove only the affected region of the gland so that the healthy part continues to function normally.
Surgery for pheochromocytoma
Treatment for pheochromocytoma is done, in most cases, with surgery to try to remove the maximum tumor from the affected adrenal gland.
Surgery for pheochromocytoma is done under general anesthesia, and in most cases the doctor chooses to remove the entire affected adrenal gland to reduce the risk of the tumor appearing again. However, if the other gland is also affected or if it has already been removed previously, the doctor removes only the affected portion of the gland, keeping the part healthy.
Generally, the healthy gland is able to maintain its function and produce the hormones necessary for the body. However, when this production is compromised the doctor can prescribe hormone replacement, which can be done for a lifetime.
Treatment for malignant pheochromocytoma
Although rare, pheochromocytoma may also be a malignant tumor, and in such cases, after surgery it may be necessary to do chemotherapy or radiation therapy to eliminate all malignant cells or metastases, depending on the degree of tumor progression.
Signs of improvement
The first signs of improvement appear about 1 week after starting treatment with the medicines and include a decrease in blood pressure and heart rate. Already after surgery, all symptoms disappear completely. However, in the case of malignant cancer, some symptoms or signs of cancer with metastases such as unexplained pain or weight loss, for example, can still be maintained.
Signs of worsening
Signs of worsening are more frequent while treatment is not started and may include increased tremor seizures, severe headache and shortness of breath, as well as a marked increase in blood pressure and heart rate.
