Phaeochromocytomas are rare tumours of chromaffin cells which produce catecholamines

Presenting features may include:
  • hypertension 
  • headache 
  • palpitations 
  • diaphoresis (=excessive sweating) 
  • nausea and vomiting 

10% are familial, as part of MEN II, neurofibrosis or Von Hippel Lindau syndrome 
10% are bilateral, 10% are malignant and 10% are extraadrenal 

Extraadrenal sites include the organ of Zuckerkandl and bladder. 

Diagnosis is by 24 hour urinary VMA. Localisation is then by CT/MRI. 

Management is surgical with pre operative alpha blockade (prazosin or phenoxybenzamine)

Small print gem: Metoclopramide must be avoided in patients with phaechromocytoma as it increases noradrenaline release via presynaptic dopamine receptor blockade, which in the presence of a phaechromocytoma can cause severe hypercatecholaminaemia. 

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Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)