Pheochromocytoma history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]Mohammed Abdelwahed M.D[3]
Overview
Common symptoms of pheochromocytoma include episodes of palpitations, sweating and headaches.[1] Most patients are asymptomatic. Less common symptoms include cardiomypathy and episodic hypotension.[2] Patients may have a history of recurrent attacks of palpitation or family history of pheochromocytoma. Patients may show symptoms of other multiple endocrine neoplasias associated diseases such as that of medullary thyroid cancer and hyperparathyroidism.
History and Symptoms
History
Patients suffering from pheochromocytoma may have a positive past medical history of recurrent attacks of palpitation or panic attacks. Family history of MEN2B increases chances of familial pheochromocytoma.
Common Symptoms
Common symptoms of pheochromocytoma are secondary to sympathetic nervous system hyperactivity. Symptoms usually subside in less than one hour and they may include:
- Palpitations especially in epinephrine producing tumors.[3]
- Anxiety often resembling that of a panic attack
- Sweating
- Headaches occurs in 90 % of patients.
- Paroxysmal attacks of hypertension but some patients have normal blood pressure.
- It may be asymptomatic and discovered incidentally after screening for MEN patients.
Less Common Symptoms
Less common symptoms include:
- Cardiomyopathy: rare symptom due to catecholamine excess mimics takotsubo cardiomyopathy.[4] Patient improves after medical treatment or surgical removal of the tumor.
- Epinephrine secreting masses can cause episodic hypotension.[5]
Symptoms of Associated diseases
Pheochromocytoma patients may show symptoms of other diseases in MEN2 syndromes such as:
- Hyperparathyroidism
- Marfanoid features
- Medullary thyroid cancer
- The patient may show symptoms associated with von Hippel-Lindau: The mean age at presentation is about 30 years. The onset can sometimes be before the age of 10. [6]
References
- ↑ Stein PP, Black HR (1991). "A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution's experience". Medicine (Baltimore). 70 (1): 46–66. PMID 1988766.
- ↑ Baguet JP, Hammer L, Mazzuco TL, Chabre O, Mallion JM, Sturm N; et al. (2004). "Circumstances of discovery of phaeochromocytoma: a retrospective study of 41 consecutive patients". Eur J Endocrinol. 150 (5): 681–6. PMID 15132724.
- ↑ Bravo EL, Gifford RW (1993). "Pheochromocytoma". Endocrinol Metab Clin North Am. 22 (2): 329–41. PMID 8325290.
- ↑ Kassim TA, Clarke DD, Mai VQ, Clyde PW, Mohamed Shakir KM (2008). "Catecholamine-induced cardiomyopathy". Endocr Pract. 14 (9): 1137–49. doi:10.4158/EP.14.9.1137. PMID 19158054.
- ↑ Bravo EL (1994). "Evolving concepts in the pathophysiology, diagnosis, and treatment of pheochromocytoma". Endocr Rev. 15 (3): 356–68. doi:10.1210/edrv-15-3-356. PMID 8076587.
- ↑ Walther MM, Reiter R, Keiser HR, Choyke PL, Venzon D, Hurley K; et al. (1999). "Clinical and genetic characterization of pheochromocytoma in von Hippel-Lindau families: comparison with sporadic pheochromocytoma gives insight into natural history of pheochromocytoma". J Urol. 162 (3 Pt 1): 659–64. PMID 10458336.