PHEOCHROMOCYTOMA - CURRENT DIAGNOSIS AND MANAGEMENT

BACKGROUND Pheochromocytoma is a catecholamine-secreting tumor of chro maffin cells that causes hypertension. OBJECTIVE To review the clinica l presentation, diagnosis, and treatment of this disease. SUMMARY Pheo chromocytoma 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, measurem ents of catecholamines and their metabolites in the plasma and urine m ay be normal between ''attacks'', and other conditions can elevate the se values. The clonidine suppression test confers specificity to the c linical and laboratory findings, and magnetic resonance imaging is the most reliable method of locating a tumor. Surgical resection is succe ssful in 90% of patients; however, the disease is fatal if it is not d etected and treated. CONCLUSIONS Pheochromocytoma should be suspected in patients with paroxysmal or sustained hypertension, particularly if symptoms are present.