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Adrenal medulla & pheochromocytoma

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

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Adrenal medulla & pheochromocytoma

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

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

  3. 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

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

  5. 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

  6. 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

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

  8. 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)

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