Phaechromocytoma

Question 1

What is phaechromocytona?

Answer 1

Tumors of SNS that secrete noradrenaline adrenaline and its metabolites

Question 2

Whats 10% rule? And whats the most common site? Association?

Answer 2

Extra adrenal 10% , B/L 10% , malignant 10%
Organ of zuckerkandl, adjacent to the bifurcation of aorta
Some associated with MEN and von hipple lindau xd

Question 3

Clinical features?

Answer 3

Episodic
Symptoms- 
Anxiety 
Panic attack 
Tremors 
Sweating 
Headache 
Chest pain 
Raynaud’s

Signs- 
Fever
Htn/hypo
Tachy/arrhythmia 
Bradycardia 
Glycosuria
Polyuria
Nocturia

Question 4

Dx?

Answer 4

1. measurement of 24 hr urinary metanephrines (most sensitive and specific)
2. resting plasma catecholamines
3. CT adb to lacalize adrenal tumours

Question 5

Tx?

Answer 5

Removal of tumour if possible

Complete alpha and beta blockade before sx (alpha first then beta- phenozybenzamine then propranolol)