Phaeochromocytoma Flashcards
What is Phaeochromocytoma?
Tumour of Chromaffin cells (cells that prod adrenaline in Adrenal Medulla) –> excessive secretion of Adrenaline
What type of hormone is Adrenaline?
Cathecholamine (which function as Neurotransmitters)
What is the function of Adrenaline as a Neurotransmitter? (2 things)
- Stimulates Sympathetic NS
- Responsible for “fight or flight” response
What is the 10% Rule of Tumour Patterns that Phaeochromocytomas follow? (4 things)
- 10% = Malignant
- 10% = Extra-adrenal
- 10% = Bilateral
- 10% = Familial
What is the Classic Triad of Phaeochromocytoma? (3 things obv)
- Episodic headache
- Sweating
- Tachycardia
What are the other CF of Phaeochromocytoma? (6 things)
- Episodic headache
- Sweating
- Tachycardia (+ palpitations)
- Paroxysmal AF
- Anxiety
- HTN
Why do the symptoms of Phaeochromocytoma fluctuate with peaks and troughs?
Bc adrenaline in Phaeochromocytoma is secreted in bursts –> giving periods of worse or better symptoms
What tests should you do for sus Phaeochromocytoma? (4 things)
- 24 hr urine metanephrines
- FBC (high WCC)
- Abd CT / MRI (for localization)
- Meta-iodobenzylguanidine scan (chromaffin-seeking isotope) (for localization)
Why is URINE metanephrines tested for instead of SERUM?
Bc serum levels will fluctuate beh = unreliable
Why is testing for METANEPHRINES better than testing for ADRENALINE? (3 things)
- Bc ADRENALINE has short half life in blood (few mins)
- Metanephrines (breakdown prod of adrenaline) = longer half life
- So Metanephrine levels fluctuate less = more reliable
What are the management options for Phaeochromocytoma? (3 things)
- Adrenalectomy surgery to remove tumour (definitive treatment)
- Alpha blockers (e.g phenoxybenzamine)
- Beta blockers once estabished on Alpha blockers
binyameen
What should be done to reduce risk of anaesthetic and surgery for Adrenalectomy for Phaeochromocytoma?
MEDICALLY manage symptoms before surgery
