Clinical presentation, biochemical parameters and localization of catecholamine-secreting tumors

Background The diagnosis of these catecholamine-secreting tumors requires clinical awareness of the various presentations and syndromes in which these tumors are found. Any suspicion of a pheochromocytoma warrants aggressive diagnostic intervention. The aim of the present paper is to describe clinical manifestations, biochemical work-up and localization of pheochromocytoma. Methods Basic diagnostic method is urinary catecholamines and/or their metabolites. For confirmation, plasma catecholamines, other neuropeptides, and clonidine suppression test can be helpful in confirming the diagnosis. Results Once the diagnosis of pheochromocytomas has been established, alpha receptor blockade should be instituted prior to further investigations. Localization of the tumor is essential prior to surgical intervention. CT or MRI scanning are the first line modalities for localization of these tumors. If CT or MRI scan fails to localize the tumor, the patient has recurrent/malignant disease, or bilateral disease is suspected, then I-131 or I-123 MIBG scanning should be performed. Conclusions Pheochromocytoma are potentially lethal but usually benign tumors. High degree of clinical suspicion and accurate work-up is essential for successful outcome.