Pheochromocytoma

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pheochromocytoma

[‚fē·ō‚krō·mō·sī ′tō·mə]
(medicine)
A tumor of the sympathetic nervous system composed principally of chromaffin cells; found most often in the adrenal medulla.

Pheochromocytoma

 

(also medullary chromaffinoma), a tumor of the cortical layer of the adrenal glands or sympathetic paraganglia that is characterized by the increased secretion of epinephrine and norepinephrine. The condition usually develops in youth or early middle age. The chief symptom is secondary hypertension, which may be persistent (often reaching a critical point with increased arterial pressure) or intermittent. The disorder is rarely found in its latent form, or without hypertension.

During severe attacks, pheochromocytoma is marked by a sudden and sharp increase in arterial pressure, draining of blood from the skin and mucous membranes, coldness of the extremities, chills, palpitation, headache, dizziness, shortness of breath, and tachycardia or, less frequently, bradycardia. The blood usually shows increased levels of sugar and leucocytosis. Casts, or cylinders, and protein are observed in the urine. The attack may last from several minutes to several hours; copious urination often accompanies its ending. Hypertensive crises may result from emotional disturbances, physical stress, chilling of the body, overheating, deep abdominal palpation, or pressure exerted on the tumor by body movements. The attacks grow more frequent and severe with the advance of the disease. Death may occur as a result of brain hemorrhage or severe cardiac insufficiency (pulmonary edema). Pheochromocytoma during pregnancy endangers both the mother and the fetus; early removal of the tumor is therefore indicated—or, alternatively, termination of the pregnancy.

The diagnosis of pheochromocytoma is based on its characteristic symptoms during an attack, the results of urine analysis (that is, sharply increased secretion of catecholamines), and X-ray examinations (specifically, roentgen diagnosis through the injection of oxygen into the cellular tissue surrounding the adrenal glands). The condition is also identified through its rapid improvement following the intravenous injection of adrenolytic agents, such as troparphene and phentolamine. Surgery is the method of treating the disease.

REFERENCE

Feokhromotsitoma. Moscow, 1965.

N. R. PALEEV

References in periodicals archive ?
A similar case reported in 1990 indicated that adrenal cortical adenomas causing clinical features of phaeochromocytoma and elevated 24 hour urinary catecholamines have been reported rarely and that patients with hypertension and on long term medication of beta blockers may have an increased urinary norepinephrine excretion (6).
phaeochromocytoma) may also be related to RET but usually occur later in life.
She had occasional episodes of palpitations, headache and sweating and provisionally diagnosed her to be a case of phaeochromocytoma. On preoperative evaluation, patient had pallor, oedema, with blood pressure 180/100mmHg, pulse 82/min.
van Minderhout et al., "Somatic loss of maternal chromosome 11 causes parent-of-origin-dependent inheritance in SDHD-linked paraganglioma and phaeochromocytoma families," Oncogene, vol.
Due to the synchronous nature of her lesions, genetic investigations were performed, diagnosing familial phaeochromocytoma and paraganglioma as a result of succinate dehydrogenase subunit-B mutation.
* FDG PET/CT may be considered for follow-up post therapy in select cases of phaeochromocytoma (proven malignant; SDHB mutation; extra-adrenal primary; phaeochromocytoma/ paraganglioma without relevant preoperative hormone secretion).
INTRODUCTION: Phaeochromocytoma, a tumour of the adrenal medulla, deriving from chromaffin cells produces catecholamines.
Magnesium was established as the treatment of choice for the control of hypertensive response to tracheal intubation in preeclampsia, (8) haemodynamic instability in tetanus and in the perioperative management of phaeochromocytoma. (9) The first doubleblinded randomised comparison of crystalloids versus colloids for resuscitation in trauma was the product of many years of research in the field of fluid management.
The use of magnesium in conditions where catecholamine excess is prevalent, such as in tetanus (8) and phaeochromocytoma, (9) has recently been described and the ability of magnesium infusions to lower catecholamine levels in a patient with tetanus has been demonstrated.
Anesthesia for phaeochromocytoma. Can J Anaesth 1988;35:526-34http://dx.doi.org/10.1007/BF03026905.
[7.] Subramaniam R, Pandit B, Sadhasivam S, Sridevi KB, Kaul HL: Retro peritoneoscopic excision of phaeochromocytoma - haemodynamic events, complications and outcome.
Although most urological surgeons thought the tumour was malignant in the preoperative discussion, so benign and malignant phaeochromocytoma cannot be distinguished on the basis of size.