QUESTION: At age 47, my husband has been diagnosed with a rare type of high blood pressure, for which surgery is being advised.
Although his doctor tried to explain the facts about a "pheochromocytoma," we are still confused and distressed.
We hope you will find this question interesting enough to publish an answer in your column.
ANSWER: It is certainly an interesting condition, but can also be most confusing.
Even the name is more than most people can manage to say.
Broken down to its Greek origins the word means "dusky (pheo) colored (chromo) cell (cyt) tumor (oma)", and it is in fact a tumor of chromaffin cells that secrete chemicals called catecholamines.
These chemicals produce a number of reactions in the body.
Typically a patient will experience episodic sweating, headaches, and palpitations and will be found to have an elevated blood pressure when tested.
Additional symptoms of flushing, abdominal pain, constipation, shortness of breath, nausea and vomiting may occur, but not all symptoms occur in all patients.
At first the symptoms come on infrequently and last for but fifteen minutes or so, but with passing time, both the severity and frequency of the attacks increase.
Although the physical examination may be normal, a urine test will show an increased level of catecholamines.
Testing a 24 hour urine specimen for various other chemicals which result from the chemical breakdown of catecholamines will usually lead to an accurate diagnosis.
The next problem is to determine the location of the tumors.
They average 5 to 6 cm.
in size, usually weigh from 50 to 200 gm, but can grow as large as several kilograms.
About 80 percent of the time they are found in the adrenal gland, which perches on the kidney.
However they may be found in the glands on both sides of the body (in about 10 percent of the cases) and may be located in other areas of the body as well.
A variety of imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) are used to complement scintigraphy, which uses radio active isotopes to locate the tumors.
Surgery is needed to permanently remove the tumors, and the patient usually passes through a period of medical management when various medications are used to assure that the hypertension and other symptoms are controlled before the operation is performed.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
