Pheochromocytoma: current diagnosis and management

BACKGROUND Pheochromocytoma is a catecholamine-secreting tumor of chromaffin cells that causes hypertension.

OBJECTIVE To review the clinical presentation, diagnosis, and treatment of this disease.

SUMMARY Pheochromocytoma can mimic a number of other diseases, making recognition difficult. Hypertension may be paroxysmal or sustained. The signs and symptoms of pheochromocytoma are mostly due to hypercatecholaminemia, hypertension, complications, or coexisting diseases; however, measurements of catecholamines and their metabolites in the plasma and urine may be normal between "attacks", and other conditions can elevate these values. The clonidine suppression test confers specificity to the clinical and laboratory findings, and magnetic resonance imaging is the most reliable method of locating a tumor. Surgical resection is successful in 90% of patients; however, the disease is fatal if it is not detected and treated.

CONCLUSIONS Pheochromocytoma should be suspected in patients with paroxysmal or sustained hypertension, particularly if symptoms are present.