oa South African Family Practice - Pheochromocytomas / paragangliomas and two cases : case study
Pheochromocytomas are catecholamine-producing neuroendocrine tumours that arise from the adrenal medulla or extramedullary pheochromoblasts with highly variable clinical presentation, including episodes of headache, sweating, palpitations and hypertension. Due to the non-specificity of the symptoms there is usually a delay between the onset of symptoms and the final diagnosis. To make a firm diagnosis, biochemical testing of the blood (catecholamines) or urine (metanephrines and VMA) are mandatory. Many stimuli increase circulating catecholamines and metabolites and must receive due attention to prevent false-positive results. Therapeutically, surgery is the gold standard. To minimise complications during and post surgery the lesion(s) should be carefully localised via imaging studies. Adequate pre- and postoperative medical treatment is important. The history, diagnosis and therapy of two patients - the one with a paraganglioma of the organ of Zuckerkandl, the other with a intra thoracic paraganglioma are presented.
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