Pheochromocytoma

Question: Does anyone know of other medical conditions that mimic a pheochromocytoma? 24 Hour urine test was positive for catecholamines, episodes of increased heart rate, high blood pressure, followed by periods of no problems. MRI and MIBG scan negative for a tumor and Dr's say they have no answers. Anyone have any ideas? wouldnt thyroid problems show in blood work? I was told thyroid was normal.

Answer: thyrotoxicosis.if thyroid hormone levels are normal ,paraneoplastic syndrome with increased catecholamines ,

Question: Only if you have or know someone with a pheochromocytoma? I would like to know what kind of symptoms you experienced before diagnosis. Please don't quote website information, as I can look that up for myself. Thank-you!

Answer: High blood pressure, temporary or permanent. Episodes of headache, sweating, and heart beating, weight loss, abdominal pain, diabetes.

Question: Lungs infected with pheochromocytoma, any treatment? My friend's mom infected with pheochromocytoma on both of her lung in early October. It is still in the early stage, no obvious symptoms yet. Is there any treatments to cure pheochromocytoma? And please recommend some good hospital for this type of disease. Thank you.

Answer: Good website: www.mayoclinic.com/health/pheochromocytoma/DS00569/DSECTION=3

Question: do plasma free metenephrines check for anything besides pheochromocytoma? ? I know this is mainly what is checks for but can it find other things if it's not a pheochromocytoms?

Answer: Normal plasma concentrations of metanephrines exclude the diagnosis of pheochromocytoma, whereas normal plasma concentrations of catecholamines and normal urinary excretion of metanephrines do not. Tests for plasma metanephrines are more sensitive than tests for plasma catecholamines or urinary metanephrines for the diagnosis of pheochromocytoma. Although pheochromocytoma may be excluded by normal plasma concentrations of metanephrines, an abnormal test result does not always positively confirm the presence of a tumor. Elevated plasma concentrations of metanephrines were found in a few patients with secondary hypertension or cardiac failure. Elevated concentrations of total metanephrines have also been reported in patients with renal failure. When plasma concentrations of metanephrines are increased in the presence of either heart failure or kidney disease, additional diagnostic techniques, including imaging studies, are necessary.

Question: Does pheochromocytoma manifest neurological symptoms? i know it there are episodes of anxiety and what not but does it cause seizures?

Answer: I have not heard of a pheochromocytoma case associated with seizures. In looking this up, apparently it can happen with severe hypertension. From http://emedicine.medscape.com/article/124059-overview "Neurologic complications: A pheochromocytoma-induced hypertensive crisis may precipitate hypertensive encephalopathy, which is characterized by altered mental status, focal neurologic signs and symptoms, or seizures. Other neurologic complications include stroke due to cerebral infarction or an embolic event secondary to a mural thrombus from a dilated cardiomyopathy. Intracerebral hemorrhage also may occur because of uncontrolled hypertension."

Question: Is anyone familiar with Pheochromocytoma,a tumor located on the adrenal gland?

Answer: Pheochromocytomas are tumors of the adrenal gland which produce excess adrenaline. Pheochromocytomas arise from the central portion of the adrenal gland which is called the adrenal medulla. The adrenal medulla is responsible for the normal production of adrenaline which our body requires to help maintain blood pressure and to help cope with stressful situations. A tumor which arises from the adrenal medulla and overproduces adrenaline can be a deadly tumor because of the severe elevation in blood pressure it causes. Symptoms of Pheochromocytomas The classical symptoms of pheos are those attributable to excess adrenaline production. Often these patients will have recurring episodes of sweating, headache, and a feeling of high anxiety. The following symptoms are listed from the most common to the least common: Headaches (severe) Excess sweating (generalized) Racing heart (tachycardia and palpitations) Anxiety / nervousness (feelings of impending death) Nervous shaking (tremors) Pain in the lower chest or upper abdomen Nausea (with or without nausea) Weight loss Heat intolerance

Question: Has anyone had positive or negative experiences with Pheochromocytoma -- tumor on the adrenal gland?

Answer: pheochromycytoma is a aldosterone secreting tumor of the adrenal glands. Often the first signs are high blood pressure (usually very high) and low potassium blood levels. Labs test and imaging will diagnose and it can be effectively treated. This is not a form of cancer.

Question: where can i find a pheochromocytoma surgeon?

Answer: Ask NORD, the National Organisation for Rare Disorders.

Question: Does anyone have pheochromocytoma? or know of anyone with this? I have been plagued by all of the symptoms and am now awaiting the results of the tests. (If it's not this then I don't know what I will do...) THey have even said it's just "panic or anxiety attacks... I know that it's not that. I am not the panicky person and the symptoms are so real and scary. sweaty, shaky, weird feeling floods thru veins, blood pressure goes way up and pulse also. Headache and cold tingly hands and feet. Also mouth is numb and doesn't want to work very well. I have been tested for diabetes and have been taking my sugars and they are fine. They sent me home from the hospital with Ativan to take when these "episodes" start...I don't want a tranquilizar I want to feel normal. Any advise would be helpful.

Answer: I doubt you have pheochromocytoma as it is very rare but I guess it can do no harm in having the tests done. Lorazepam (ativan) is highly addictive and not the safest of drugs to be taking. I would strongly recommend that you read this page http://www.benzo.org.uk/manual/ and also this page http://www.benzo.org.uk/ashbzoc.htm I wonder if your symptoms could be drug induced either you stopped a medication too quickly and got withdrawal effects or an adverse reaction either a side effect or from prolonged usage. Also your symptoms could also appear in some who is using excess alcohol It is good that you are actively trying to rule out medical causes for your symptoms with your doctors help but I could look into other things. You could also try cutting out caffeine, aspartame and alcohol to see if any of those symptoms above calm down. Research any drugs that you are currently taking especially ones that work on the central nervous system and also research any drugs that you took or stopped taking around the time of onset of the symptoms.

Question: How well can a person live with only one adrenal gland? I have pheochromocytoma and need to have my left adrenal removed. My epenephrines are out of whack and hypertension is the big concern for now. It should be in control after surgery.

Answer: I know someone who has all theirs removed and it has no noticable effect. Except they say it makes them less excitable in personality.

Question: What is detected in Protein Metanephrine besides pheochromocytoma? I'm confused about this. I guess 24 hr urine test was abnormal and she's doing this one. So does it look for various types of adrenal tumors or what?

Answer: phaeochromocytoma is a condition where you have high amounts of adrenaline in the blood. one of the causes of phaeochromocytoma is a growth or tumor (90% are benign) in the adrenal gland one of the breakdown products of adrenaline is metanephrine which is excreted in the urine. another breakdown product you could find in the urine is the cathecolamine or VMA with only the 24 hour urine collection test, it does not really show where the tumor is or what kind of tumor it is. if the patient is suspected to have phaeochromocytoma (ie from the abnormal urine results) the patient will have to have further investigations like having a CT or MRI or a radioisotope scan (MIBG)

Question: What other conditions can mimic Pheochromocytoma? 23 yr old fem. Night sweats, headaches, ear infections, feeling that I cant swallow, anxiety/dizzy spells with tachycardia, feeling like I cant breathe. Diagnosed with high blood pressure. Blood tests for thyroid so far came out ok, stress test came out negative for WPW, 24 hr urine for metaepinephrines came out negative for Pheochromocytoma. I keep getting these symptoms, bp is still high 145/90 even with Norvasc and now the dr want to check thyroid and adrenal glands again with PET scan. Could the original tests come back false negative?what else could this be? Im skinny, no drugs. During the attacks my bp wasnt measured, I was in school, work or the train at those times, but at the doctors appt, which was on my day off, it was 145/100 when I felt I was resting. The attacks were definitely more severe than that.

Answer: labile essential hypertension anxiety/panic disorder paroxysmal atrial tachycardia (not just wpw) mastocytosis amphetamine or cocaine addiction.....just askin' you know thyroid problems well, you prolly aren't in menopause.... Possibly renal artery stenosis????????? Anyway, I doubt ear infections are related to this thing. Did they check for increased intracranial pressure? Have you had any urine leakage? Are you overweight (this goes along with the increased intracranial pressure thing) You should have an opthalmologist look at your optic nerve to check for papilledema. Yes, original tests can be falsely negative, but that is pretty uncommon. The high blood pressure can be a red herring. With pheo it is usually super high and episodic. Yours isn't that high. It is possible that you have essential hypertension plus panic attacks. You might be treated more effectively with a beta blocker or with clonidine. Well, I won't second guess your internist, good luck on your treatment, hope ya feel better very soon.

Question: I had a patient on the ventilator who has spurious elevated carboxyhemoglobin levels? Non-smoking 37 year old, with a diagnosis of benign pheochromocytoma which was causative factor for adrenal hemorrhage. The COHb readings within a couple of days was between 3 and 6% . What gives?? I do not understand the source of elevated carboxyhemoglobin?

Answer: Easy peasy lemon squeezy !!! Increased endogenous production of CO is a feature of any condition with increased heme catabolism. Any group of conditions associated with hemolysis (increased rate of RBC destruction) results in increased heme catabolism and therefore increased production of CO. An additional consideration, in peer reviewed literature there are a couple of citations that show increased CO (up to 10 to 12%) in some packed red cells for transfusion. Lets put all this together. Heme catabolism from the "assumed" hematoma that surely formed in this patient would be a source of Hb degradation. And, also assuming that this patient did receive multiple transfusions. Severe inflammatory diseases also have shown a very slight increase in endogenous CO production. This is thought to be from the increased expression of heme oxygenase (the enzyme culprit for CO production) induced by inflammatory cytokines.

Question: Pheochromocytoma... and vertigo? I have this type of tumor and I was wondering if you would get vertigo with the symptoms...

Answer: My pheochromocytoma was removed about 5 years ago and I have incidents of vertigo, mostly while just lying in bed. Check out Wikipedia. It has very good and accurate information last time I checked. Feel free to e-mail me if you have more questions. Be sure to put Pheo in your subject line. Good luck to you!

Question: Pheochromocytoma question? Anyone else suffer from it or know someone who has it? Are these symptoms common with Pheo? Pallor, Loss of Weight, Constant Anxiety, Sinus Tachycardia, Colour change to nail beds, thinning of skin, dark circles under eyes, chest/arm pain, indigestion/burping, dark patches on skin, small lumps under skin, occasional elevation in blood pressure, cold sweaty hands and feet, trembling, loss of balance, visual disturbances and dilation of pupils? What causes Pheo? Thanks for your answers, I have had a number of blood tests but not sure if the Pheo would show up. Doc... Can you tell me if it would show up in the following tests (i.e. abnormal levels):- Full Blood Count Thyroid Function (TSH) T4 and TFT Free Serum Calcuim Serum Potassium Serum Sodium Liver Function Kidney Function Urine Sample (basic test) Creatinine Urea and Electrolytes EGFR Random Glucose Albumin Serum Bilirubin Folate Blood Cultures Chest X Ray ECG These are all tests I have done recently, FBC has been done three times, I've had 2 ECG's and my Thyroid tests have been done today for a 4th time as all the previous levels were normal. Medicinenet.com is useful but it is an American site and some of the tests done in the UK are different to America, like the T3 test, you have to pester the GP's here for that test and they are still reluctant to do it. An MRI over here if routine would take up to 3 months to get the appointment.

Answer: There is a small gland above the kidneys which is known as the suprarenal or adrenal gland. It is a hormone producing factory which synthesizes very important hormones for our body. Its inner portion is known as 'medulla' . the inner portion synthesizes epinephrine/adrenaline, which is a hormone required for 3f reaction (fright, fight and flight) or in other words whenever one gets in danger this hormones comes to the rescue. Think of this situation as if u r walking down an empty street at night and suddenly 3 wild dogs start chasing u. U d run like hell, sweat a lot and all the blood in ur body d get diverted to skeletal muscle, heart and brain, which d inevitably push the blood pressure to higher level. These r the basic symptoms of pheochromocytoma. Pheochromocytoma occurs when the cells of adrenal medulla are converted into a tumor/neoplasm and start secreting epinephrine even when it is not required by the body, cause is usually unknown/idiopathic. Surest way of knowing it is that if u get tested for it. Standard blood tests d give a hint but ct scan of abdomen is much more sensitive in picking it up.

Question: surgery for pheochromocytoma,is it risky?

Answer: Pheochromocytoma is a tumor of special cells (called chromaffin cells), most often found in the middle of the adrenal gland. Description Because pheochromocytomas arise from chromaffin cells, they are occasionally called chromaffin tumors. Most (90%) are benign tumors so they do not spread to other parts of the body. However, these tumors can cause many problems and if they are not treated and can result in death. However surgery in early stages can be done easily without running in any risk. In any case surgery can not be avoided and it had to be done and the disease treated as CANCER IS STILL AN ENIGMA. Treatment in all cases begins with surgical removal of the tumor. Before surgery, medications such as alpha-adrenergic blockers are given to block the effect of the hormones and normalize blood pressure. These medications are usually started seven to 10 days prior to surgery. The surgery of choice is laparoscopic laparotomy, which is a minimally invasive outpatient procedure performed under general or local anesthesia. A small incision is made in the abdomen, the laparoscope is inserted, and the tumor is removed. The patient can usually return to normal activities within two weeks. If a laparoscopic laparotomy cannot be done, a traditional laparotomy will be performed. This is a more invasive surgery done under spinal or general anesthesia and requires five to seven days in the hospital. Usually patients are able to return to normal activities after four weeks. After surgery, blood and urine tests will be done to make sure hormone levels return to normal. If the hormone levels are still above normal, it may mean that some tumor tissue was not removed. If not all tumor can be removed (as in malignant pheochromocytoma, for example) drugs will be given to control high blood pressure.-