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A pheochromocytoma can cause wild fluctuations in blood pressure with normal blood pressure in between spells. This can make the condition more difficult to detect. The graph shows a nine-day period of short, irregular bursts in blood pressure due to a pheochromocytoma. The lower points represent the bottom number of the reading (diastolic pressure). The higher points show the top number of the reading (systolic pressure). For example, the first burst in blood pressure is seen on day two with a reading of 250/110 millimeters of mercury.
A pheochromocytoma (fee-o-kroe-moe-sy-TOE-muh) is a rare, usually noncancerous (benign) tumor that develops in an adrenal gland. Usually, this type of tumor affects one of your two adrenal glands, but it can affect both.
If you have a pheochromocytoma, the tumor releases hormones that cause either episodic or persistent high blood pressure. Untreated, a pheochromocytoma can result in severe or life-threatening damage to other body systems, especially the cardiovascular system.
Most people with a pheochromocytoma are between the ages of 20 and 50, but the tumor can develop at any age. Surgical treatment to remove a pheochromocytoma usually returns blood pressure to normal.
Signs and symptoms of pheochromocytomas often include:
Less common signs or symptoms may include:
Spells may occur spontaneously or may be triggered by such factors as:
Foods high in tyramine, a substance that affects blood pressure, also can trigger a spell. Tyramine is common in foods that are fermented, aged, pickled, cured, overripe or spoiled. These foods include:
Certain medications that can trigger a symptomatic spell include:
The signs and symptoms of pheochromocytoma can be caused by a number of conditions. So it’s important to get a prompt diagnosis.
Although high blood pressure is a primary sign of a pheochromocytoma, most people with high blood pressure don’t have an adrenal tumor. Talk to your doctor if any of the following factors are relevant to you:
The endocrine system includes the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas, ovaries (in females) and testicles (in males).
Researchers don’t know what causes a pheochromocytoma. The tumor develops in specialized cells, called chromaffin cells, situated in the center of an adrenal gland. These cells release certain hormones, primarily adrenaline (epinephrine) and noradrenaline (norepinephrine), that help control many body functions, such as heart rate, blood pressure and blood sugar.
Adrenaline and noradrenaline are hormones that trigger your body’s fight-or-flight response to a perceived threat. The hormones prompt higher blood pressure, a faster heart rate and a boost in other body systems that enable you to react quickly. A pheochromocytoma results in the irregular and excessive release of these hormones.
While most chromaffin cells reside in the adrenal glands, small clusters of these cells are also in the heart, head, neck, bladder, back wall of the abdomen and along the spine. Tumors in these chromaffin cells, called paragangliomas, may result in the same effects on the body.
Pheochromocytoma can occur in the inherited syndrome multiple endocrine neoplasia, type IIB (MEN IIB). In addition to pheochromocytoma, people with MEN IIB also have thyroid cancer and tumors of nerves in the lips, mouth, eyes and digestive tract.
People with rare inherited disorders have an increased risk of developing a pheochromocytoma or paraganglioma, and tumors associated with these disorders are more likely to be cancerous. These genetic conditions include the following:
High blood pressure can damage multiple organs, particularly tissues of the cardiovascular system, brain and kidneys. Untreated, high blood pressure associated with pheochromocytomas can result in a number of critical conditions, including:
Rarely, a pheochromocytoma is cancerous (malignant), and the cancerous cells spread to other parts of the body (metastasize). Cancerous cells from a pheochromocytoma or paraganglioma most often migrate to the lymph system, bones, liver or lungs.
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