A)
Pathology: 85-90% in ardrenal, 10-20% of sporadic pheos are
malignant, extra-adrenal pheos are 2-3x more likely malignant, extra-ardrenal
sites (paraganglia, bladder, organ of Zuckerkandl, post. mediastinum);
MEN Ila (MTC, pheo, parathyroid hyperplasia), MEN Ilb (MTC, pheo,
mucosal nuromas, ganglioneuromatosis).
B) Manifestations: Hypertension, sweats,
headaches, palpitations, tachycardia, anxiety, nausea, vomit, diarrhea,
abdominal pain, faint, paresthesias, shock.
C) Diagnosis: Plasma Epi. And NE levels;
24 hour urine for Epi., NE, metanephrine, normetanephrine, VMA;
clonidine supression; CT, MRI; I*-MIBG.
D) Management: Medical Rx of HTN, medical
support, surgical resection.
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