Pheochromocytoma
Our pheochromocytoma specialists in New York are here for you. Our team of endocrine doctors near you are dedicated to supporting your success and ensuring that you regain your metabolic health and overall wellness.
What Is Pheochromocytoma?
Pheochromocytoma, also called elevated adrenaline levels, is a rare type of neuroendocrine tumor that originates in the chromaffin cells of the adrenal glands. Pheochromocytomas are characterized by the excessive and unregulated production and secretion of catecholamines (e.g., adrenaline, noradrenaline), leading to their elevated levels in the body. Biochemically, elevated plasma and urinary catecholamines and their metabolites (metanephrines) are hallmark findings. Despite its benign nature, there is a risk of malignant transformation, underscoring the importance of clinical vigilance. The tumor's episodic catecholamine release significantly impacts cardiovascular function, necessitating a high index of suspicion for accurate identification and management.
What Are the Causes of Pheochromocytoma?
Pheochromocytoma is primarily caused by genetic mutations, which play a pivotal role in its pathogenesis. Approximately 30-40% of cases are linked to hereditary syndromes, with notable associations including Multiple Endocrine Neoplasia type 2 (MEN 2), von Hippel-Lindau (VHL) syndrome, Neurofibromatosis type 1 (NF1), and hereditary paraganglioma-pheochromocytoma syndromes involving mutations in the SDHB, SDHC, and SDHD genes. These mutations lead to dysregulation of cellular proliferation and catecholamine synthesis within the adrenal medulla. In sporadic cases, the etiology remains less well-defined, though somatic mutations in various oncogenes and tumor suppressor genes are implicated. The presence of these genetic abnormalities results in the formation of neoplastic chromaffin cells, which exhibit unregulated secretion of catecholamines. This aberrant hormone production underlies the clinical manifestations of pheochromocytoma, contributing to episodic hypertension, tachycardia, and other adrenergic symptoms.
The excessive catecholamine secretion can lead to a variety of symptoms, including:
Episodic or sustained high blood pressure
Headaches
Palpitations
Sweating
Tremors
Anxiety and panic attacks
Pheochromocytoma is typically diagnosed through a combination of:
Biochemical tests: Measuring the levels of catecholamines and their metabolites in the blood or urine
Imaging studies: Techniques such as CT, MRI, or MIBG (123I-metaiodobenzylguanidine) scans to locate the tumor
What Are the Treatments and Therapies for Pheochromocytoma?
The primary treatment for pheochromocytoma is surgical removal of the tumor, which is typically performed after initial medical management to control the excessive catecholamine effects. Pheochromocytomas can sometimes be cancerous in which case radiation and chemotherapy can be initiated after surgery.
Medications, such as alpha-blockers and beta-blockers, may be used to stabilize the patient's condition before and after surgery.
How Can Well by Messer Help You with Pheochromocytoma?
Pheochromocytomas can be life threatening if left untreated, so prompt detection and treatment is necessary. At Well by Messer, our pheochromocytoma specialists are able to conduct blood and urine testing in office, allowing for rapid diagnosis. Imaging typically accompanies biochemical testing, but treatment can be initiated while waiting for results. Once a diagnosis is made, we follow up with patients very closely to manage medications, especially blood pressure medication. Blood pressure must be optimized for a few weeks before surgery and our providers are very familiar with the titration of the medication to achieve this goal. At the time of diagnosis, our providers will also arrange for a consultation with a surgeon to start planning for surgery.
Meet the Well by Messer (WBM) Team
Under the leadership of top endocrinologist in New York, Dr. Caroline Messer, our caring and talented team of board-certified endocrinologists, psychologists, nutritionists, and personal trainers will be dedicated to supporting your success and regaining your metabolic health at our metabolic centers in Manhattan.
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