DEFINITION

Pheochromocytoma is a tumor of
special cells (called chromaffin cells),
most often found in the adrenal
medula.
CAUSES
• Pregnancy
• Lifting
• Urination
• Drug
• Withdrawal from drug
• Panic attacks
• Spinal cord injuries
RISK GROUP
• Equal occurrence in females and males
• Can occur at any age. Most common in people
between 30 and 60
• Usually on Right side
• Incidence decreases with age
Clinical manifestation
• headaches
• excess sweating
• racing heart
• rapid breathing
• anxiety/nervousness
• nervous shaking
• pain in the lower chest or upper abdomen
• nausea
• heat intolerance
PHEOCHROMOCYTOMA IN CHILDREN
AND PREGNANCY

PHEOCHROMOCYTOMA IN CHILDREN

• Pheochromocytoma is rare in children, but occurs most commonly between

the ages of 8 and 14 years. Diagnosis of pheochromocytoma can be more
difficult at this age, because other childhood cancers (e.g. neuroblastoma)
can also elevate adrenaline compounds in the body.
• Pheochromocytomas in children are more likely to be bilateral (on both the
left and right sides of the body) and outside the adrenal glands. For this
reason, transabdominal surgery is usually performed to remove the tumor.
PHEOCHROMOCYTOMA IN PREGNANCY
• Although rare, pheochromocytoma in pregnancy
can be very dangerous. Because x rays are to be
avoided in pregnancy, MRI and/or ultrasound is
used to locate the tumor. Alpha-adrenergic
blocking agents to reduce blood pressure are
given to the woman as soon as the diagnosis is
made.
• If the woman is in the first two trimesters of
pregnancy, most often the tumor is removed. In
the third trimester, the woman usually remains on
alpha-adrenergic blocking agents until a
cesarean section can be safely performed.
INVESTIGATION
• Genetic testing
• CT scan or MRI
• 24 hours urine collection
• Angiography
• Radioactive iodine
TREATMENT
• Beta blockers
• IV phentolamine
• Radiation therapy
• Chemotherapy
• Alpha blockers
• Phenoxybenzamine
• labetalol (to slow the heart rate)
• atenolol
• reninangiotensin
• catecholamines
SURGICAL TREATMENT

• Adrenalectomy
• Laparotomy
• Laparoscopy
• Transabdominal surgery
CT ABDOMEN
COMPLICATION

• Heart failure
• Stroke
• Kidney failure
• Acute respiratory distress
• Confusion
• Psychosis
• Seizures
• Visual impairment
• Premature death
CONT…
Long-term exposure to these
hormones can
cause:

• Damage to your heart muscle

• Congestive heart failure
• An increased risk of diabetes
PRE-OPERATIVE CARE
• Request a dietary consultation to
discuss with client about a diet
high in vitamin and protein.
• Use careful medical and surgical
asepsis when providing care and
treatments.
• Monitor the results of laboratory
test of electrolytes and glucose
level.
• Teach the client to turn, cough
and perform deep-breathing
exercise.
• Frequently observe whereby the
blood pressure and fluid are
optimized
• Surgery and nursing care are
explained to patient.
• Prepare patient for for major
abdominal surgery
POST-OPERATIVE CARE
• Record vital sign, measure intake and
output, and monitor electrolytes on a
frequent schedule, especially during
the 48 hour after surgery.
• Assess body temperature, WBC level
and wound drainage, change dressing
using sterile technique
• Encourage early ambulation; slow
progression of diet when bowel sound
return.
• Administer iv hydrocortisone is given
as directed to prevent adrenal crisis
• Monitor serum sodium, potassium
and glucose for any abnormalities.
• Assess dressing for leakage
internally, and after it has been
changed, assess wound for sign for
infection.
High magnificant micrograph
of a pheochromocytoma
showing the nested
arrangement of
cells(Zellballen)and stippled
chromatin.
Histopathology of
adrenal
pheochromocytoma.

Adrenectomy
specimen
 Micrograph of
pheochromocytoma

Bilateral of
pheochromocytoma
Group members…
DarmaDevi
Prashalah
Letchumi
Suhanimah
Thevika
Adilah Amni
Nurshuhada
Nuraisyah
Hajar Nursyamimi
Nurasyikin