Need for Screening & Epidemiology of pheochromocytoma and paraganglioma

There is a huge need for screening for pheochromocytomas and paragangliomas. As mentioned, 4-10% of all patients with high blood pressure have underlying for pheochromocytomas or paraganglioma that nobody has figure out. It is approximated that 75 million Americans suffer from hypertension. This means that there are about 3-7.5 million Americans with pheochromocytomas and paragangliomas Only a fraction of all these -- less than one tenth of one percent -- are being diagnosed, and an even smaller fraction are being offered surgery. With minimally invasive adrenalectomy, the vast majority of these patients can be cured in less than 30-40 minutes. Surgical removal of the adrenal tumor may save you from developing future strokes, heart attacks, and arrhythmias (for instance, atrial fibrillation), heart attacks, and premature death. This is why people with high blood pressure need to be screened for pheochromocytomas and paragangliomas. below

Also, if you have any of the below signs/symptoms you need to be screened for pheochromocytomas and paragangliomas:

• Hypertension (high blood pressure) at a young age (< 50 years of age) • Hypertension with an adrenal incidentaloma • High adrenaline “spells”. This may be very variable but include o Palpitation (heart racaing and pounding) o Pallor (face turning pale, then often followed by flushing o Tremor (shakiness) o Headache o Sweating o Spells may be spontaneous or precipitated by change in body position, anxiety, medications (e.g., metoclopramide, anesthetic agents), and maneuvers that increase intraabdominal pressure (e.g. going to the bathroom). • Hypertension in a family with any family member with an adrenal tumor (pheochromocytoma/paraganglioma) • Resistant hypertension (i.e. poor response to medications) • Hypertension requiring many medications • Hypertension and a family history of early-onset (< 50 years of age) hypertension or cerebrovascular accident (stroke) at a young age • Hypertension that is episodic (paroxysmal) • A familial syndrome that predisposes to catecholamine-secreting tumors (e.g., multiple endocrine neoplasia type 2, neurofibromatosis type 1, von Hippel- Lindau disease, familial pheochromocytoma & paraganglioma syndromes) • An incidentally discovered adrenal mass with imaging (X-ray) characteristics consistent with pheochromocytoma and paraganglioma • Pressor response during anesthesia, surgery, or angiography • Idiopathic dilated cardiomyopathy (enlargement of the heart)