Pheochromocytoma
A rare, usually benign tumour of the adrenal gland that pours out the 'fight-or-flight' hormones adrenaline and noradrenaline. It causes spells of severe high blood pressure with headache, sweating, a pounding heart and pallor, and is important because it is dangerous but often curable with surgery.
What it is
A pheochromocytoma is a tumour arising from the catecholamine-producing cells in the core of the adrenal gland, which sits on top of each kidney. A closely related tumour outside the adrenal, along nerve pathways, is called a paraganglioma. These tumours secrete the stress hormones adrenaline (epinephrine) and noradrenaline (norepinephrine), usually in bursts, flooding the body with the 'fight-or-flight' response. The hallmark is episodes ('spells') of pounding, throbbing headache, heavy sweating, a racing or forceful heartbeat, pallor, anxiety and a sharp rise in blood pressure, which may last minutes to an hour and can be triggered by exertion, certain foods or medicines, or occur unpredictably. Between spells a person may feel well, and some tumours instead cause steadily raised blood pressure. Most are benign, but a minority behave aggressively, and a significant proportion are linked to inherited genetic conditions, so genetic testing is often advised. Untreated, the surges in blood pressure carry real risks to the heart and brain. The diagnosis rests on measuring the hormone breakdown products (metanephrines in blood or urine, and VMA), followed by imaging to locate the tumour. Treatment is usually surgical removal, after careful medical preparation to control the blood pressure — and it is often curative.
Key lab markers
- Plasma or urine metanephrines — the most sensitive test; markedly raised.
- Urinary VMA (vanillylmandelic acid) — a catecholamine breakdown product, classically high.
- Potassium — may be affected; part of assessing an adrenal cause of hypertension.
- Glucose — can be high, as catecholamines raise blood sugar.
- Imaging (CT or MRI) and functional scans — to locate the tumour once biochemistry is positive.
- Genetic testing — often advised, given the frequent hereditary link.
Symptoms
- Spells of pounding or throbbing headache
- Heavy sweating
- A racing, forceful or irregular heartbeat (palpitations)
- Sudden severe rise in blood pressure
- Pallor during a spell
- Anxiety, a sense of dread or tremor
- Sometimes weight loss, or high blood sugar
- Symptoms may be episodic, with well periods in between
Related symptoms
Related lab panels
When to discuss with a doctor
A pheochromocytoma should be considered when high blood pressure comes in dramatic spells with headache, sweating and palpitations; when hypertension is severe, resistant, or starts at a young age; when there is an adrenal lump found on a scan; or when there is a relevant family history or genetic syndrome. It is diagnosed by measuring metanephrines and VMA, then imaging to locate the tumour, and treated by surgical removal after careful preparation to make the blood pressure safe. Because a hormone surge can be dangerous, care is coordinated by an endocrinologist and surgical team. A hypertensive crisis — a sudden, extreme rise in blood pressure with severe headache, chest pain or neurological symptoms — is an emergency. Mediora.AI can surface the raised metanephrine or VMA pattern alongside your blood pressure that points toward this treatable tumour; confirming the diagnosis and planning treatment belong with your endocrinologist.