Adrenal medulla pheochromocytoma Klaudija Prli Mentor A mega

Adrenal medulla & pheochromocytoma Klaudija Prlić Mentor: A. Žmegač Horvat

Adrenal medulla ˝inner core˝ of the adrenal gland hormone-producing cromaffin cells amino acid tyrosin → catecholamines adrenaline (epinephrine) noradrenaline (norepinephrine) dopamine ˝adrenaline rush˝

Adrenaline or noradrenaline effects increased heart rate and blood pressure blood vessel constriction (skin and GI tract) blood vessel dilation (skeletal muscles) bronchiole dilation decreased matabolism fight-or-flight response

Fight-or-flight response • "fight-or-flight-or-freeze response“ • "fright, fight or flight response“ • "hyperarousal“ • "acute stress response"

Pheochromocytoma neuroendocrine tumor of the adrenal medulla originates in cromaffin cells of the medulla or extraadrenal cromaffin tissue excessive amounts of catecholamines, usually adrenaline and noradrenaline

Signs and symptoms skin sensations flank pain elevated heart rate elevated blood pressure palpitations anxiety (panic attacks) diaphoresis headache pallor weight loss elevated blood glucose level

Location adults: 90 % unilateral 10 % extraadrenal children: 50% adrenal 25 % bilateral 25 % extraadrenal (abdomen, thorax, urinary bladder) → most smaller than 10 cm

Diagnosis by measuring catecholamines and metanephrines in plasma or through a 24 -hour urine collection Treatment surgical resection (open laparotomy or laparascopy) →adrenalectomy prior treatment with non-specific and irreversible α adrenoceptor blocker (minimizing the possibility of intraoperative hypertension)