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{{Pheochromocytoma}}  
{{Pheochromocytoma}}  
{{CMG}} {{AE}} {{AAM}}
{{CMG}}; {{AE}} {{AAM}} {{MAD}}
==Overview==
==Overview==
Prognosis of pheochromocytoma is generally good but metastatic pheochromocytoma has a 5 year survival rate of approximately 45%.<ref name="cancergov"> National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_25_toc</ref> Massive release of [[catecholamines]] can causes damage to myocytes.
Pheochromocytoma is an [[adrenaline]] secreting [[tumor]], that usually develops in the fifth decade of life. Symptoms start with [[tachycardia]], [[hypertension]], [[headache]] and [[sweating]]. Massive release of [[catecholamines]] may cause [[hyperglycemia]], [[malignant hypertension]] and [[metastasis]]. The [[prognosis]] of pheochromocytoma is generally good but metastatic pheochromocytoma has a 5-year survival rate of approximately 50%.
==Natural History, Complication and Prognosis==
==Natural History, Complications and Prognosis==
===Complication===
===Natural History===
The massive release of [[catecholamines]] in pheochromocytoma can cause damage to myocytes.<ref name=Goldman_327>{{Harvnb|Goldman|2011|pp=327}}</ref> This damage may be due to either compromising the [[coronary microcirculation]] or by direct toxic effects on the myocytes.<ref name=Goldman_327 />
* The symptoms of pheochromocytoma usually develop in the fifth decade of life.
Other complication may include:
* Common symptoms are with [[tachycardia]], [[hypertension]], [[headache]], and [[sweating]].
*[[Hyperglycemia]]
* If left untreated, [[hyperglycemia]] and  [[Hypertensive crisis|hypertensive emergency]]. It may lead to [[heart failure]] and[[Stroke|cerebrovascular strokes]].
*[[Refractory hypertension]]
* If [[malignant]], It can [[metastasize]] to [[lymph nodes]], [[bones]], [[lungs]], and [[liver]]. <ref name="pmid28324046">{{cite journal| author=Pamporaki C, Hamplova B, Peitzsch M, Prejbisz A, Beuschlein F, Timmers HJLM et al.| title=Characteristics of Pediatric vs Adult Pheochromocytomas and Paragangliomas. | journal=J Clin Endocrinol Metab | year= 2017 | volume= 102 | issue= 4 | pages= 1122-1132 | pmid=28324046 | doi=10.1210/jc.2016-3829 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28324046  }}</ref>
*[[Malignant hypertension]]
 
===Complications===
Common complications of pheochromocytoma include:
* Damage to [[cardiac myocytes]] due to either a compromise of the [[coronary microcirculation]] or the direct toxic effects of [[catecholamines]] on [[cardiac myocytes]].<ref name="Goldman_327">{{Harvnb|Goldman|2011|pp=327}}</ref>
*[[Hyperglycemia]] due to opposition of [[insulin]] effect by high doses of [[adrenaline]] secreted by the [[tumor]].
*[[Malignant hypertension]] that may cause [[Cerebrovascular event|cerebrovascular]] accidents such as:
**[[Intracranial hemorrhage]]
**[[Acute coronary syndrome]]
**[[Aortic dissection]]
**[[Heart failure]]
*[[Metastasis]] to:
**[[Lymph node|Lymph nodes]]
**[[Bones]]  
**[[Lung|Lungs]]  
**[[Liver]]
 
===Prognosis===
===Prognosis===
The 5-year survival in the setting of metastatic disease (whether identified at the time of initial diagnosis or identified postoperatively as recurrent disease) is 40% to 45%
* The [[prognosis]] of pheochromocytoma is generally good with treatment. The 5-year survival rate in patients with [[metastatic]] pheochromocytoma is approximately 50%.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_25_toc</ref>
* Prognosis and survival rate varies with the location of the primary [[tumor]], sites of [[Metastasis|metastases]], [[Tumor]] burden, and rate of progression.
* [[Metastasis]] to the [[brain]] and [[liver]] has a worse [[prognosis]] than other [[metastases]].
 
'''Post-surgical prognosis'''
* Factors associated with a favourable [[prognosis]] include:
** Small [[tumor]] size
** Short duration of surgery
** [[Systolic blood pressure]] < 160 mmHg
** Low levels of [[urinary]] [[catecholamines]].<ref name="pmid20336320">{{cite journal| author=Murphy MM, Witkowski ER, Ng SC, McDade TP, Hill JS, Larkin AC et al.| title=Trends in adrenalectomy: a recent national review. | journal=Surg Endosc | year= 2010 | volume= 24 | issue= 10 | pages= 2518-26 | pmid=20336320 | doi=10.1007/s00464-010-0996-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20336320  }}</ref>
* Approximately 10% recur after being [[Resection|resected]].
* Recurrence is more common in patients with familial pheochromocytoma and extra-[[Adrenal gland|adrenal]] [[tumors]].<ref name="pmid11297571">{{cite journal| author=Plouin PF, Duclos JM, Soppelsa F, Boublil G, Chatellier G| title=Factors associated with perioperative morbidity and mortality in patients with pheochromocytoma: analysis of 165 operations at a single center. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 4 | pages= 1480-6 | pmid=11297571 | doi=10.1210/jcem.86.4.7392 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11297571  }}</ref>
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Latest revision as of 20:21, 28 July 2020

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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] Mohammed Abdelwahed M.D[3]

Overview

Pheochromocytoma is an adrenaline secreting tumor, that usually develops in the fifth decade of life. Symptoms start with tachycardia, hypertension, headache and sweating. Massive release of catecholamines may cause hyperglycemia, malignant hypertension and metastasis. The prognosis of pheochromocytoma is generally good but metastatic pheochromocytoma has a 5-year survival rate of approximately 50%.

Natural History, Complications and Prognosis

Natural History

Complications

Common complications of pheochromocytoma include:

Prognosis

Post-surgical prognosis

References

  1. Pamporaki C, Hamplova B, Peitzsch M, Prejbisz A, Beuschlein F, Timmers HJLM; et al. (2017). "Characteristics of Pediatric vs Adult Pheochromocytomas and Paragangliomas". J Clin Endocrinol Metab. 102 (4): 1122–1132. doi:10.1210/jc.2016-3829. PMID 28324046.
  2. Goldman 2011, pp. 327
  3. National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_25_toc
  4. Murphy MM, Witkowski ER, Ng SC, McDade TP, Hill JS, Larkin AC; et al. (2010). "Trends in adrenalectomy: a recent national review". Surg Endosc. 24 (10): 2518–26. doi:10.1007/s00464-010-0996-z. PMID 20336320.
  5. Plouin PF, Duclos JM, Soppelsa F, Boublil G, Chatellier G (2001). "Factors associated with perioperative morbidity and mortality in patients with pheochromocytoma: analysis of 165 operations at a single center". J Clin Endocrinol Metab. 86 (4): 1480–6. doi:10.1210/jcem.86.4.7392. PMID 11297571.