Pheochromocytoma medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

Treatment with alpha blockers (example: phenoxybenzamine) followed by beta blockers (example: atenolol) is required before surgery. Adjunctive chemotherapy and radiation are used in metastatic disease.

Medical Therapy

Any surgical option requires prior treatment with both the non-specific alpha adrenoceptor blocker (phenoxybenzamine) to counteract hypertension and the beta-1 adrenoceptor antagonist atenolol to reduce cardiac output. Given before surgery, these can also block the effect of a sudden release of adrenaline during tumour resection, which would otherwise endanger the anaesthetised patient.

Chemotherapy

Metastatic pheochromocytoma is treated with Averbuc protocol which is a combination of cyclophosphamide, vincristine, and dacarbazine.[1]

Radiation

131I-MIBG radiation therapy has been used for the treatment of MIBG-avid metastases.[1]

Contraindicated medications

Pheochromocytoma is considered an absolute contraindication to the use of the following medications:

References

  1. 1.0 1.1 National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_179_toc

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