A pheochromocytoma is a rare tumour that arises in the cells of the adrenal glands. They are usually benign, meaning they are noncancerous. However, they can cause the adrenal gland to overproduce the hormones epinephrine and norepinephrine, which can result in a number of symptoms.
If left untreated, a pheochromocytoma can result in severe or life-threatening damage to other parts of the body, especially the cardiovascular system.
A pheochromocytoma can appear at any age, however, they are most prevalent between the ages of 20 and 50.
The adrenal glands are small organs that secrete hormones – such as epinephrine, norepinephrine, androgens, estrogens, aldosterone, and cortisol – which help regulate a range of bodily functions like your immune system, blood sugar levels, blood pressure control, and metabolism.
As the name implies, they are located near the renal area, just above the two kidneys. Although small, they are complex glands. Cells in the inner area of the adrenal glands – known as the adrenal medulla – secrete hormones called catecholamines (which include epinephrine, norepinephrine and dopamine). Pheochromocytomas form in these cells, causing an abnormal amount of catecholamines to be released.
Most people with a pheochromocytoma have attacks or ‘spells’ of symptoms, which occur when the tumour excretes hormones. These spells can either occur spontaneously, or be triggered by stimulation of the sympathetic nervous system, which usually controls the release of these hormones.
Triggers include physical exertion, stress, anxiety or fear, surgery and anesthesia, foods high in tyramine, and some drugs and medication.
The three main symptoms include:
• Heart palpitations
• Heavy sweating
As well as:
• High blood pressure
• Shortness of breath
Surgical removal of the tumour is the only effective treatment. Removal of the adrenal gland is called an adrenalectomy. This can be performed in two ways:
Open adrenalectomy – An open adrenalectomy is often required when either the adrenal glands or the tumours are abnormally large. In this procedure a single incision is made either in the abdominal wall just under the ribcage, or the back or sides. The surgeon then disconnects the adrenal gland from the blood vessels and surrounding tissue, removes it via the incision and closes the wounds.
Laparoscopic or robotic adrenalectomy – Laparoscopic adrenalectomies are less invasive than open surgery and as such the recovery time is much quicker. This is where the adrenal glands are removed via several small incisions using fibre-optic technology or the da Vinci robot.
If the tumour cannot be surgically removed, medications can be prescribed to manage the imbalance of hormones being released into your body.
Although rare, if a pheochromocytoma is found to be cancerous, further treatments such as chemotherapy and radiotherapy may be required after surgical removal of the tumour.
We are experts in the field of adrenalectomy. In particular, Dr Mohan Arianayagam specialises in laparoscopic adrenalectomy.
While completing his Urologic Oncology fellowship at the University of Miami Miller School of Medicine there was also significant exposure to more laparoscopic surgery and it was during this time that Dr Arianayagam also honed his skills. Dr Arianayagam is one of the most experienced minimally invasive surgeons in Sydney.
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