One of the types of adrenal tumors that secret hormones ispheochromocytoma. It can be a manifestation of the syndrome of multiple diseases of the endocrine organs, when the thyroid gland, parathyroid gland is affected and neurofibromatosis is noted.
In 10% of cases, the tumor of the adrenal gland is a consequence of genetic heredity. The clinical picture is caused by excessive release into the blood of hormones - catecholamines and the response of organs and systems to hormonal imbalance.
Features of the disease
The pheochromocytoma is a tumor lesion of the adrenal glands, namely, the medulla, thereby increasing the release of adrenaline and norepinephrine.
The neoplasm is located in a capsule and has a good network of blood vessels. Its size is about 5 centimeters (-10 cm). Occurs at the age of 20-50 years, but 10% of cases occur in children. In 90% of patients with histological examination, a benign structure is diagnosed, but in other cases, cancer is detected.
The lesion is often one-sided, but there is a tumor on both sides.
What is the danger of pheochromocytoma?
Given the main clinical sign of pheochromocytoma - a persistent increase in blood pressure, including diastolic, it is worth highlighting possible complications:
- changes in the vessels of the fundus, vascular kidney damage, hemorrhages in the brain accompanied by neurologic symptoms are observed on the part of the cardiovascular system;
- neuropsychic disorders (psychosis, neurasthenia);
- endocrine disorders manifested by hyperglycemia (increased glucose level), increased admission to the blood of adrenal hormones;
- from the side of the circulatory system, there is a thickening of the blood, an increase in ESR;
- gastrointestinal disorders in the form of pain in the abdomen, vomiting and increased salivation.
Without treatment, the disease can lead to serious complications up to a lethal outcome.
Symptomatically, the tumor manifests itself as high blood pressure figures, because it produces a large number of hormones that can increase blood pressure.
The disease is characterized by catecholamine hypertensive crises, which can not always be cured by antihypertensive agents, which are used with the usual increase in pressure.
Malignant tumors often produce dopamine. They are characterized by metastasis in the lymph nodes, bones and lungs.
The hypertensive crisis is manifested by increased pressure, chills, a feeling of fear, increased sweating, anxiety, pallor of the skin, headache and even convulsions.
The development of a crisis can be provoked by emotional overloads, stresses, severe physical activity, alcohol or overheating.
Of the complications, it is worthwhile to focus on stroke, pulmonary edema, myocardial infarction, acute renal insufficiency and exfoliating aortic aneurysm. Also, it should be noted catecholamine shock, in which there are sharp pressure jumps.
In pregnant women, the diagnosis of pheochromocytoma is difficult, since the disease is masked by toxicosis, preeclampsia and eclampsia.
How to recognize pheochromocytoma?
The first signs of the disease may be a rise in pressure in the form of a crisis (the figures can reach 230/130 mm Hg) or in a constant form. The duration of the crisis can vary from a few minutes to hours, after which a sharp decrease in pressure is observed up to 100/60 mm Hg.
At this time, the person is worried about headache, nausea, palpitations, sweating and a feeling of heat. Also, the psycho-emotional state changes and irritability appears.
The diagnosis begins with the registration of elevated blood pressure figures, which are recorded both at the time of the crisis and during the intercrossing period.
For the purpose of further diagnosis, organs that are most often affected (eyes, heart, kidneys) are examined.
From instrumental methods ultrasound, angiography of renal, adrenal arteries, excretory urography and computed tomography are assigned.
Pharmacological tests are conducted to stimulate or block the release of catecholamines into the blood. Laboratory recorded hyperglycemia, increased catecholamines in urine and blood.
Treatment and removal
The main medical direction is surgical removal of the tumor. Before the operation, it is necessary to lower blood pressure with the help of antihypertensive agents, which will prevent the development of intraoperative complications.
In the postoperative period, pressure control and correction of medications are required. In the case of a malignant process, chemotherapy courses are also conducted.
Prognosis and survival
When diagnosedpheochromocytoma, a favorable prognosis provided timely surgical removal of the tumor and prevention of severe complications. 5-year survival after surgery is 95% for benign neoplasm and 44% for cancer. Also, it is worth noting the likelihood of a relapse (1,%), so it is necessary to observe the endocrinologist..