How is pheochromocytoma diagnosed and treated?

  Pheochromocytoma is a chromophobic tissue originating from the adrenal medulla, sympathetic ganglion or other sites. The tumor releases large amounts of catecholamines continuously or intermittently, causing persistent or paroxysmal hypertension and metabolic disturbances in several organs. The disease is more common in males than females and is most common in 20-50 year olds. Most cases can be cured if diagnosed and treated early.  (a) Clinical manifestations: mainly due to the action of a large number of catecholamines on adrenal receptors, with cardiovascular symptoms as the main cause.  1, cardiovascular system manifestations: paroxysmal hypertension is the characteristic manifestation of the disease, usually blood pressure is not high, the blood pressure rises suddenly during the attack, accompanied by severe headache, pale face, sweating, tachycardia, anxiety, nausea, vomiting, etc.. With the prolongation of the disease and frequent attacks, some patients may develop persistent hypertension with paroxysmal exacerbation. Some patients may also experience alternating hypertension and hypotension and shock. It can also cause cardiac arrhythmia, myocardial damage and even heart failure.  2. Metabolic disorders: increased basal metabolism, disorders of glucose metabolism, disorders of lipid metabolism and electrolyte disorders may occur.  3, can be accompanied by damage to the digestive system, urinary system and hematological system.  (Blood and urine catecholamines and their metabolites: blood and urine catecholamines are increased in both paroxysms and persistence, and the urinary levels of catecholamines and their metabolites, vanillylmandelic acid (VMA), are increased.  2.Glucose and glucose tolerance test.  3.Pharmacological test: glucagon stimulation test.  4, imaging tests: ultrasound, CT, MRI examination for localization and diagnosis, in addition, isotope-labeled m-iodobenzylguanidine can be used for scintillation of adrenal glands and other parts of the scan.  Treatment measures] (a) seizure period: immediately give isoamyl nitrite inhalation, oxygen inhalation, phentolamine 1-5mg intravenous slow push, stop pushing when the blood pressure drops to 160/100mmHg, followed by 10-50mg dissolved in 5% G.S 500ml drip. You can give 20mg 3/day, observe the cardiac function, ECG changes and possible cardiovascular diseases.  (ii) Surgical treatment: after clear diagnosis of the site and nature.  (iii) Drug therapy: tyrosine hydroxylase inhibitor methyl intertyrosine to hinder the biosynthesis of catecholamines, or 131I-MIBG (inter-iodobenzylguanidine) treatment can be obtained certain effect. Phenylbenzylamine 20-100mg/day orally to control blood pressure.  Most pheochromocytomas are benign and can be surgically eradicated. Removal of pheochromocytoma has certain risks, so we should pay attention to the sudden rise of blood pressure and cardiac arrhythmia and deal with them in time. The effect of treatment can be judged by blood pressure, blood and urine catecholamine levels about one month after surgery.