Pheochromocytoma

Overview

Pheochromocytoma is a rare type of tumor that usually develops in the adrenal glands, which are small glands located above the kidneys. These glands help produce hormones that regulate important body functions, including blood pressure, heart rate and the body’s response to stress.

A pheochromocytoma can release excessive amounts of stress-related hormones, causing episodes of very high blood pressure and other symptoms. Some tumors release hormones continuously, while others do so in sudden bursts. Most pheochromocytomas are not cancerous, but they still need careful medical evaluation because they can affect the heart, blood vessels and overall health.

Similar tumors can also develop outside the adrenal glands, usually along nerve tissue in the chest, abdomen or pelvis. These are often called paragangliomas. Evaluation and treatment are usually managed by specialists in endocrinology, surgery, radiology and other related fields.

Symptoms

Symptoms of pheochromocytoma can vary from person to person. Some people have frequent symptoms, while others have occasional attacks that may last minutes to hours. Symptoms may be triggered by physical activity, stress, certain body positions, medical procedures or, in some cases, without any clear trigger.

• High blood pressure, either constant or occurring in episodes
• Headaches, sometimes severe
• Fast or pounding heartbeat
• Excessive sweating
• Trembling or shaking
• Pale skin or flushing
• Shortness of breath
• Chest discomfort
• Anxiety or a feeling of panic
• Nausea, abdominal discomfort or constipation
• Unexplained weight loss in some cases

Because these symptoms can also occur with many other conditions, having them does not necessarily mean a person has pheochromocytoma. However, repeated episodes of these symptoms, especially with high blood pressure, should be assessed by a healthcare professional.

Causes and Risk Factors

Pheochromocytoma occurs when certain hormone-producing cells grow abnormally. In many cases, the exact reason is not known. The tumor may occur at any age, though it is more often found in adults. It can affect both men and women.

Some pheochromocytomas are linked to inherited genetic conditions. This means a person may be born with a gene change that increases the risk of developing these tumors. Genetic conditions associated with pheochromocytoma may also increase the risk of other endocrine or nerve-related tumors. For this reason, genetic counseling or testing may be recommended for some patients, particularly those who are younger, have tumors in both adrenal glands, have tumors outside the adrenal glands or have a family history of related conditions.

Risk factors may include a personal or family history of pheochromocytoma, paraganglioma or certain inherited syndromes. Even when no family history is known, medical teams may still consider genetic evaluation depending on the patient’s overall findings.

Diagnosis

Diagnosis usually begins with a detailed medical history and physical examination, including blood pressure assessment. The doctor may ask about symptom patterns, family history and any triggers for episodes.

Laboratory tests are commonly used to measure hormone levels or hormone breakdown products in the blood or urine. These tests help determine whether the body is producing excessive stress-related hormones. Because results can be influenced by stress, diet, illness and some medications, healthcare professionals provide specific instructions before testing when needed.

If laboratory results suggest pheochromocytoma, imaging tests may be used to locate the tumor. These may include scans of the abdomen or other areas of the body. In selected cases, specialized imaging may be recommended to look for tumors outside the adrenal glands or to assess whether the condition has spread.

Genetic testing may also be discussed, especially when there are features suggesting an inherited condition. A confirmed diagnosis and treatment plan require evaluation by qualified healthcare professionals.

Treatment Options

Treatment depends on the tumor’s location, size, hormone activity, whether it has spread and the patient’s overall health. In many cases, surgery to remove the tumor is the main treatment. Because pheochromocytoma can cause sudden changes in blood pressure during treatment, careful preparation before surgery is very important.

Before surgery, doctors often use medications to help control blood pressure and reduce the effects of excess hormones. The specific approach is individualized and closely monitored. Patients may also receive guidance on fluid intake, salt intake or other preparation measures, depending on their medical condition and the treating team’s plan.

Surgery may be performed using minimally invasive or open techniques, depending on the tumor and patient factors. After surgery, hormone levels and blood pressure are monitored. Some people need ongoing follow-up to check for recurrence or to monitor inherited risk factors.

If the tumor cannot be fully removed, has spread or returns after treatment, additional options may be considered. These can include further surgery, targeted radiation-based treatments, systemic therapies or close monitoring. The best approach is determined by a multidisciplinary medical team.

When to See a Doctor

Medical evaluation is important if a person has repeated episodes of severe headache, sweating and a racing heartbeat, especially if these occur with high blood pressure. People with difficult-to-control blood pressure, sudden blood pressure spikes or a family history of pheochromocytoma or related endocrine tumors should also discuss this with a doctor.

Urgent medical care is needed for chest pain, severe shortness of breath, fainting, symptoms of stroke, confusion or extremely high blood pressure readings accompanied by concerning symptoms. These situations may indicate a medical emergency.

Pheochromocytoma is uncommon, but it is a treatable condition in many cases when properly identified and managed. Early specialist evaluation can help clarify the cause of symptoms and guide safe, appropriate care.