Print Friendly, PDF & Email

almostadoctor app banner for android and iOS almostadoctor iPhone, iPad and android apps almostadoctor iOS app almostadoctor android app


Phaeochromocytoma is a neuroendocrine tumour of the medulla of the adrenal glands. It secretes large quantities of  the catecholamines noradrenaline, and to a lesser extent, adrenaline.



Rule of 10: 10% familial, 10% bilateral, 10% extra-renal, 10% malignant



  • Severe headaches
  • Severe hypertension (eg 210/100) and orthostatic hypotension, both fluctuating
  • Cardiac tachyarrythmias (eg SVTs)
  • A plethora of other symptoms, including flushing+unwell+wt loss (like in hyperthyroid), panic/anxiety, sweating, pallor, hyperglycaemia, pyrexia, abdominal pain …
  • May be worsened by TCA (if you thought it was ps-somatic), beta-blockers, IV contrast



MI, heart failure, dilated cardiomyopathy, arrhythmias, stroke, coma, death



MEN 2a,2b; neurofibromatosis; Von Hippel-Lindau syndrome.



  • Initial best test to rule out phaeochromocytoma: metadrenaline from blood.
  • Confirmed by 3x 24-hour collection of urine catecholamines.
  • CT abdo.
  • Nuclear imaging: MIBG: chrommafin-seeking isotope scan, for extra-renal tumours




  • Stabilise patient: ALPHA-blockers (phenoxybenzamine) BEFORE beta-blockers, to prevent hypertensive crisis from unopposed alpha-stimulation.


  • Definitive Rx: surgical resection of adrenal gland.

Life-long follow up

  • Malignant recurrence may present late


Read more about our sources

Related Articles

Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

Leave a Reply